The biomechanical therapeutic effects of cilateral biportal endoscopic treatment of lumbar spondylolisthesis
Abstract
Purpose: To compare the therapeutic effects of unilateral biportal endoscopic lumbar interbody fusion (ULIF) using a 3D printed cage and posterior lumbar interbody fusion (PLIF) using a 3D printed cage in the treatment of lumbar spondylolisthesis. Method: To retrospectively analyze the clinical data of 105 patients with lumbar spondylolisthesis in Qianfoshan Hospital of Shandong Province from Among them, 50 cases were treated with ULIF (ULIF group) and 55 cases were treated with PLIF (PLIF group). The operation time, intraoperative blood loss, postoperative drainage volume, hospitalization days, postoperative complications, waist and leg pain vas scores, and OSTC pain scores, were all measured. The operation time, intraoperative blood loss, postoperative drainage volume, hospitalization days, postoperative complications, waist and leg pain vas scores, and Oswestry Disability Index (ODI) were compared between the two groups. Results: The operation time in the ULIF group was longer than that in the PLIF group, and the difference was statistically significant (p < 0.05). There were statistically significant differences in intraoperative blood loss, postoperative drainage volume, and hospital stay (p < 0.05). There were 1.1 cases of cerebrospinal fluid leakage in the ULIF group and the PLIF group after surgery, and 3 cases of infection in the PLIF group. No other complications occurred. No other complications occurred. The difference in the incidence of complications between the two groups was statistically significant (p < 0.05). Patients in both groups were followed for 6 to 12 months. In the ULIF group and the PLIF group using 3D printed intervertebral fusion cages, the intervertebral fusion rates were as high as 1 to 1.5 times the intervertebral fusion rate. In the ULIF group and the PLIF group using 3D printed intervertebral fusion cages, the intervertebral fusion rates at 6 months (80%/81.8%, p > 0.05) and 12 months (96%/96%, p > 0.05) after surgery were statistically undifferenced. Conclusion: For patients with lumbar spondylolisthesis, ULIF group can achieve similar efficacy to PLIF group using a 3D printed fusion cage. They are similar in terms of pain relief and improvement in functional disability. ULIF group has less intraoperative and postoperative bleeding and shorter hospitalization days, lower infection rate and less damage to muscle tissue. ULIF has less intraoperative and postoperative bleeding and shorter hospitalization days, lower infection rate and less damage to muscle tissue. However, ULIF takes a long time, has a long learning curve and requires high equipment.
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