Safety and short-term effects study of Wiltse and posterior median approach lumbar interbody fusion surgery for treatment of lumbar disc herniation
Objective To compare and analyze the safety and short-term effects of Wiltse and posterior median approach transforami-nal lumbar interbody fusion(TLIF)for the treatment of lumbar disc herniation(LDH).Methods A retrospective analysis was conducted on 86 patients with LDH who underwent TLIF treatment in the Department of Orthopedics at the Second Affiliated Hospital of Zhengzhou University from January 2019 to December 2022.The patients were divided into the Wiltse approach group(Wiltse group,38 patients)and the posterior median approach group(posterior median group,48 patients)according to the surgical approach.The baseline data of the two groups were com-pared,and the operation time,intraoperative blood loss,and time to ambulation were recorded.The lumbar spine function before and 6 months af-ter surgery were evaluated,and the Japanese Orthopaedic Association(JOA)score and Numeric Rating Scale(NRS)score were compared.Results Therewas no significant difference in baseline data between the two groups(P＞0.05).The operation time and time to ambulation in the Wiltse group were shorter than those in the posterior median group,and the intraoperative blood loss was less than that in the posterior medi-an group,with statistical significance(P＜0.05).There was no significant difference in JOA and NRS scores between the two groups before sur-gery(P＞0.05).At 6 months after surgery,the JOA score in the Wiltse group was higher than that in the posterior median group,and the NRS score was lower than that in the posterior median group,with statistical significance(P＜0.05).There was no significant difference in the inci-dence of complications between the two groups(P＞0.05).Conclusion Both Wiltse and posterior median approaches TLIF can improve lum-bar spine function and relieve pain in patients with LDH,and they are both safe.However,the Wiltse approach TLIF has better effects in impro-ving lumbar spine function and relieving pain,with shorter operation time and less intraoperative blood loss,which is beneficial for postoperative rehabilitation.
Lumbar disc herniationWiltse approachPosterior median approachTransforaminal lumbar interbody fusion
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