[Objective]To compare the clinical outcomes of percutaneous endoscopic lumbar discectomy(PELD)versus minimally inva-sive transforaminal lumbar interbody fusion(MISTLIF)for lumbar lateral recess stenosis.[Methods]A retrospective study was conducted on 62 patients who received surgical treatment for lumbar lateral recessional stenosis.According to the preoperative doctor-patient communica-tion,27 patients had spinal canal decompressed with PELD(the decompression group),while other 35 patients were treated with MISTLIF(the fusion group).The documents regarding to perioperative period,follow-up and images were compared between the two groups.[Results]All patients in both groups had operation performed successfully without serious surgical complications.The decompression group proved significantly superior to the fusion group in terms of operation time[(54.4±11.4)min vs(104.4±10.5)min,P＜0.001],total incision length[(0.9±0.1)cm vs(6.2±1.5)cm,P＜0.001],intraoperative blood loss[(38.5±18.8)ml vs(85.1±50.8)ml,P＜0.001],postoperative walking time[(10.7±6.6)days vs(29.1±12.7)days,P＜0.001]and hospital stay[(6.1±1.6)days vs(8.5±2.6)days,P＜0.001].All patients in both groups were followed up for more than 12 months,and the decompression group resumed full weight-bearing activity significantly earlier than the fusion group[(44.6±12.6)days vs(57.7±10.0)days,P＜0.001].The VAS scores for lower back pain and leg pain,as well as ODI score signifi-cantly declined over time in both groups(P＜0.05),whereas which were not statistically significant between the two groups at any correspond-ing time points(P＞0.05).Radiographically,the vertebral canal area and lateral recess diameter significantly increased in both groups at the last follow-up compared with those preoperatively(P＜0.05),while the lumbar lordosis angle remained unchanged(P＞0.05).Although there was no significant difference between the two groups before operation(P＞0.05),the decompression group got significantly less spinal canal area[(165.0±7.3)mm2 vs(201.5±12.9)mm2,P＜0.001]and the lateral recess diameter[(4.1±0.4)mm vs(4.9±0.5)mm,P＜0.001]than the fu-sion group at the last follow-up,but there was no statistically significant difference in lumbar lordosis angle between the two groups(P＞0.05).[Conclusion]The clinical consequence of the two minimally invasive procedures are comparable.However,the simple decompres-sion with PELD technique takes advantages of more minimally invasive and faster recovery in the treatment of lumbar lateral recess stenosis over the MISTLIF.
NETL
NSTL
万方数据
