scholarly journals Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach

2009 ◽  
Vol 19 (2) ◽  
pp. 316-324 ◽  
Author(s):  
ShunWu Fan ◽  
ZhiJun Hu ◽  
FengDong Zhao ◽  
Xing Zhao ◽  
Yue Huang ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Invasive Procedure ◽  
Clinical Effects ◽  
Open Approach ◽  
Lumbar Interbody Fusion ◽  
Minimally Invasive Procedure ◽  
Multifidus Muscle ◽  
Muscle Changes ◽  
Conventional Open Approach

Intramuscular pressure of the multifidus muscle and low-back pain after posterior lumbar interbody fusion: comparison of mini-open and conventional approaches

2013 ◽  
Vol 19 (6) ◽  
pp. 651-657 ◽  
Author(s):  
Yoshihiro Mukai ◽  
Shota Takenaka ◽  
Noboru Hosono ◽  
Toshitada Miwa ◽  
Takeshi Fuji
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Intramuscular Pressure ◽  
Multifidus Muscle ◽  
Screw Insertion ◽  
Mini Open

Object This randomized study was designed to elucidate the time course of the perioperative development of intramuscular multifidus muscle pressure after posterior lumbar interbody fusion (PLIF) and to investigate whether the route of pedicle screw insertion affects this pressure and resultant low-back pain. Although several studies have focused on intramuscular pressure associated with posterior lumbar surgery, those studies examined intramuscular pressure generated by the muscle retractors during surgery. No study has investigated the intramuscular pressure after PLIF. Methods Forty patients with L4–5 degenerative spondylolisthesis were randomly assigned to undergo either the mini-open PLIF procedure with pedicle screw insertion between the multifidus and longissimus muscles (n = 20) or the conventional PLIF procedure via a midline approach only (n = 20). Intramuscular pressure was measured 5 times (at 30 minutes and at 6, 12, 24, and 48 hours after surgery) with an intraoperatively installed sensor. Concurrently, the FACES Pain Rating Scale score for low-back pain and the total dose of postoperative analgesics were recorded. Results With the patients in the supine position, for both groups the mean pressure values were consistently 40–50 mm Hg, which exceeded the critical capillary pressure of the muscle. With the patients in the lateral decubitus position, the pressure decreased over time (from 14 to 9 mm Hg in the mini-open group and from 20 to 10 mm Hg in the conventional group). Among patients in the mini-open group, the pressure was lower, but the difference was not statistically significant. Postoperative pain and postoperative analgesic dosages were also lower . Conclusions To the authors' knowledge, this is the first study to evaluate postoperative intramuscular pressure after PLIF. Although the results did not demonstrate a significant difference in the intramuscular pressure between the 2 types of PLIF, mini-open PLIF was associated with less pain after surgery. Clinical trial registration no.: UMIN000010069 (www.umin.ac.jp/ctr/index.htm).

scholarly journals Enhanced Recovery after an Innovative Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spinal Stenosis: A Prospective Observational Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Peng Yin ◽  
Haifeng Gao ◽  
Lijin Zhou ◽  
Daming Pang ◽  
Yong Hai ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Enhanced Recovery ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Leg Pain ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
Significant Difference ◽  
Lumbar Spinal

Background. The objective of this study was to investigate the enhanced recovery clinical effects of an innovative percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) for the treatment of patients with LSS and degenerative instability. Methods. From January 2019 to March 2020, 51 patients with single-segment LSS and degenerative instability were prospectively included in our study (ChiCTR1900020679). The Oswestry Disability Index (ODI), the visual analogue scale (VAS) on lumbar and leg pain (VAS-LBP and VAS-LP), serum creatine kinase (CK), the peak intensity of sulphur hexafluoride microbubble contrast agent (PI), and the maximal cross-sectional area of multifidus muscle (Max-CSA) around the surgical incision were assessed preoperatively, postoperatively, and at regular follow-up. Results. All patients were followed up. The mean postoperative bedridden time was 20.45 ± 2.66 hours. The ODI, VAS-LBP, and VAS-LP were improved significantly after operation compared to these data before operation in all the patients ( P < 0.05 ). The CK at 1 day after operation was higher compared to the data before the operation ( P < 0.05 ), and there was no significant difference on CK at 1 week after operation ( P > 0.05 ). The PI at 1 week after operation was higher compared to this item before operation ( P < 0.05 ), and there was no significant difference on PI at 1 month or 3 months after operation ( P > 0.05 ). The Max-CSA at 1 week after operation was higher compared to this item before the operation ( P < 0.05 ), and there was no significant difference in Max-CSA at 1 month or 3 months after operation compared with before the operation ( P > 0.05 ). Conclusions. Our results and systematic review presented the innovative PE-TLIF technique could obtain satisfactory and effective outcomes for the treatment of patients with LSS and degenerative instability. Our PE-TLIF technique also had the ability to decrease the MF injury and obtain an enhanced recovery.

scholarly journals An Innovative Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spinal Stenosis with Degenerative Instability: a prospective cohort study

2021 ◽  
Author(s):  
Peng Yin ◽  
Yi Ding ◽  
Lijin Zhou ◽  
Chunyang Xu ◽  
Liming Zhang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Controlled Study ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Degenerative Diseases ◽  
Multifidus Muscle ◽  
Lumbar Spinal

Abstract Lumbar spinal stenosis (LSS) is most common lumbar degenerative diseases for people with low back pain. Endoscopic lumbar fusion technique was considered as a promising treatment for LSS with degenerative instability. The objective of this study was to compared the clinical effects for the treatment of Lumbar spinal stenosis (LSS) with degenerative instability between the innovative percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) technique and posterior lumbar interbody fusion (PLIF) technique. Between April 2019 and December 2019, 40 patients with single-segment LSS were prospectively included in our study. Visual Analogue Scale (VAS) on lumbar and leg pain (VAS-LBP, VAS-LP), Oswestry Disability Index (ODI), serum Creatine Kinase (CK), the maximal cross-sectional area of multifidus muscle (Max-CSA) and the peak intensity of Sulphur hexafluoride microbubble contrast agent (PI) around the surgical incision by contrast-enhanced ultrasonography were evaluated preoperatively, post-operatively and at regular follow-up. All patients were followed up. The VAS-LBP, VAS-LP, ODI after operation were improved significantly compared to these data before operation in all the patients (P < 0.05). The VAS-LBP at 1 weeks, 3 months after operation in PE-TLIF group were significantly lower than these in PLIF group (P < 0.05). The injury degree of multifidus muscle evaluated by MAX-CSA and PI was significantly less in PE-TLIF group after operation(P < 0.05). There was no significant difference on the complication rate between these two groups (P > 0.05). Our results presented PE-TLIF technique could obtain comparable effective outcomes as conventional PLIF for the treatment of LSS with degenerative instability. The Patients with PE-TLIF had less muscle injury, less pain and quicker postoperative rehabilitation. (A multicenter non-randomized controlled study for percutaneous endoscope transforaminal lumbar interbody fusion (PE-TLIF) and traditional open surgery for the treatment of degenerative diseases of the lumbar spine;2019/4/13; http://www.chictr.org.cn/showproj.aspx?proj=38002; ChiCTR1900022492)

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