| Objective To investigate the clinical efficacy of extraforaminal lumbar interbody fusion (ELIF) through Wiltse approach in the treatment of single-segment Meyerding Ⅰ and Ⅱ degree degenerative lumbar spondylolisthesis.Methods Clinical data of 78 patients with single-segment Meyerding Ⅰ and Ⅱ degree degenerative lumbar spondylolisthesis admitted to Wuhan Orthopedics Hospital of Integrated Traditional Chinese and Western Medicine from October 2018 to July 2022 were retrospectively analyzed. Thirty-five patients were treated with ELIF technique through Wiltse approach (ELIF group), including 21 males and 14 females, aged (53.66±9.42) years old; 43 patients were treated with transforaminal lumbar interbody fusion (TLIF) using posterior median approach (TLIF group), including 23 males and 20 females, aged (53.09±8.73) years old. The operation time, intraoperative bleeding, postoperative drainage, bed rest time and complications were recorded. Visual analogue scale (VAS) and Oswestry dysfunction index (ODI) were used to evaluate patients of the two group.Results Seventy-eight patients were successfully completed surgery, without any complications.All patients were followed up for 12-19 months, with a mean of (12.77±1.75) months. There was no significant difference in operation time between the two groups (P>0.05). Intraoperative bleeding was significantly lower in the ELIF group than that in the TLIF group (P<0.05). And after 48 h of drain placement, postoperative drainage was significantly less in the ELIF group than that in the TLIF group (P<0.05). Mean postoperative bed rest was significantly shorter in the ELIF group than in the TLIF group (P<0.05). VAS scores were higher in the ELIF group than in the TLIF group at 3 d, 1 month, 3 months and 6 months postoperatively, but there was no statistically significant difference between the two groups at 12 months after surgery (P>0.05). At 1 month, 3 months postoperatively, there was no statistically significant difference in ODI between the two groups (P>0.05), while the ELIF group was significantly better than the TLIF group at 6 and 12 months postoperatively (P<0.05). At follow-up, the same treatment group showed improvement in ODI at each time point compared with the previous one. The excellent and good rate of postoperative intervertebral implant fusion in the ELIF group was 91.43%; while it was 97.67% in the TLIF group; the difference was not statistically significant between the two groups (P>0.05).Conclusion ELIF through the Wiltse approach for the treatment of single-segment Meyerding Ⅰ and Ⅱ degree degenerative lumbar spondylolisthesis has the advantages of less trauma, less bleeding, faster postoperative recovery, and it is a minimally invasive, safe and effective surgical method. |
