Clinical efficacy of endoscopic lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion in the treatment of lumbar disc herniation in older adult patients
10.3760/cma.j.cn341190-20250201-00167
- VernacularTitle:Endo-LIF和MIS-TLIF治疗老年腰间盘突出症的临床疗效比较
- Author:
Ming JIN
1
;
Jinhui ZHAO
;
Jiangong CUI
Author Information
1. 长治市第二人民医院屯留医院外科，长治 046100
- Publication Type:Journal Article
- Keywords:
Intervertebral disc displacement;
Surgical procedures operative;
Pain measurement;
Postoperative complications;
Comparative effectiveness research;
Patient
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(5):681-687
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of endoscopic lumbar interbody fusion (Endo-LIF) versus minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar disc herniation in older adult patients. Methods:The medical records of 120 older adult patients with lumbar disc herniation who underwent surgical treatment at Tunliu Hospital, The Second People's Hospital of Changzhi from January 2021 to January 2023 were retrospectively collected. According to different surgical methods, the patients were divided into the Endo-LIF group and the MIS-TLIF group, with 60 patients in each group. Surgery-related indicators, Visual Analog Scale score, Oswestry Disability Index score, the Japanese Orthopaedic Association score, imaging indicators, complications, and patient satisfaction were compared between the two groups.Results:Patients in the Endo-LIF group had shorter surgery duration [(76.29 ± 8.35) minutes vs. (80.85 ± 9.15) minutes, t = -11.93, P < 0.001], less intraoperative bleeding [(31.37 ± 4.57) mL vs. (45.47 ± 6.26) mL, t = -9.66, P < 0.001], shorter postoperative bed rest duration [(1.02 ± 0.54) days vs. (2.51 ± 0.83) days, t = -5.49, P = 0.042], and shorter hospital stay [(5.25 ± 1.67) days vs. (7.43 ± 2.82) days, t = -5.16, P = 0.039] compared with the MIS-TLI group. The Endo-LIF group had more intraoperative fluoroscopy sessions [(7.62 ± 2.63) times vs. (6.91 ± 1.84) times, t = 8.53, P < 0.001] compared with the MIS-TLI group. There were no statistically significant differences in Visual Analog Scale score, Oswestry Disability Index score, or Japanese Orthopaedic Association score between the two groups before and after intervention (all P > 0.05). There were no significant differences in intervertebral height index and range of motion of the affected segments between the two groups before and after intervention (both P > 0.05). The incidence of complications did not differ significantly between the two groups ( P > 0.05). However, patient satisfaction was higher in the Endo-LIF group compared with the MIS-TLI group [91.67% (55/60) vs. 78.33% (13/60), χ2 = 4.18, P = 0.041]. Conclusions:The postoperative recovery indicators at 3 months were comparable between the Endo-LIF and MIS-TLI procedures; however, the surgical indicators for the Endo-LIF procedure were more favorable. Therefore, Endo-LIF is recommended for older adult patients with lumbar disc herniation.
