Zhongguo linchuang yanjiu (May 2024)

Efficacy of robot-assisted full-endoscopic transforaminal lumbar interbody fusion in the treatment of degree Ⅰand Ⅱ lumbar spondylolisthesis

  • ZHANG Wenhui, DOU Yangyang, YANG Yuping, FAN Lizhen, ZHANG Hui, LIU Jie, TAI Huiping

DOI
https://doi.org/10.13429/j.cnki.cjcr.2024.05.006
Journal volume & issue
Vol. 37, no. 5
pp. 679 – 684

Abstract

Read online

Objective To evaluate the efficacy of robot-assisted full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) in the treatment of grade Ⅰ and Ⅱ lumbar spondylolisthesis. Methods The clinical data of 17 lumbar spondylolisthesis patients underwent robot-assisted Endo-TLIF treatment in Gansu Provincial Hospital from January 2020 to January 2022 were retrospectively collected. The postoperative hospital stay and complications were recorded. The accuracy of pedicle screw placement and the time of single screw placement were calculated. The clinical efficacy was evaluated by modified MacNab and lumbar interbody fusion was evaluated by Suk method. The related scores were recorded before operation, 1 month after operation and at the last follow-up. Results There were (126.45±17.28) min in duration of surgery, (90.00±11.25) mL in intraoperative blood loss, (4.10±0.95) times in intraoperative X-ray fluoroscopy, and (3.54±0.37) days in postoperative hospital stay. The accuracy of pedicle screw placement was 97.06 %, and average pedicle screw placement time was 9.75 min. At the last follow-up, all patients were evaluated to have good lumbar interbody fusion, with the excellent and good rate was 94.12%. One month after operation and at the last follow-up, the visual analogue scale (VAS) score was lower than that before operation, while the total score of Japanese Orthopaedic Association (JOA) was significantly higher than that before operation (P＜0.05). No dura mater injury, nerve tissue injury, screw loosening and fracture were found in all patients. Conclusion Robot-assisted Endo-TLIF in the treatment of grade Ⅰ and Ⅱ lumbar spondylolisthesis has good efficacy, and has the advantages of accurate pedicle screw placement, less trauma, short operation time, and less intraoperative blood loss, but there are problems of high cost and high radiation to patients.

Keywords