Comparison Between PE-TLIF and MIS-TLIF in the Treatment of Middle-Aged and Elderly Patients with Single-Level Lumbar Disc Herniation

Figures & data

Table 1 Patient Basic Information of Group PE-TLIF and Group MIS-TLIF

	Group PE-TLIF	Group MIS-TLIF	P value
N	39	43
Gender (male:female)	18:21	23:20	0.66
Age (years)	60.35±8.04	60.98±6.62	0.94
BMI (kg/m^2)	23.32±2.52	22.98±2.23	0.52
Levels (%)			0.57
L3-4	9(23%)	10(23%)
L4-5	27(69%)	24(56%)
L5-S1	3(8%)	9(21%)
Duration of symptoms (years)	2.24±0.92	2.00±0.76	0.20
Follow-up (months)	19.49±2.86	19.19±2.22	0.60

Abbreviations: PE-TLIF, percutaneous endoscopic transforaminal lumbar interbody fusion; MIS-TLIF, minimally invasive transforaminal lumbar interbody fusion; BMI, body mass index.

Figure 1 A case of PE-TLIF surgery.

Notes: (A and B) lumbar MRI revealed L4-5 lumbar disc herniation. (C) Frontal and (D) lateral X-ray images represented permanent positions after 3 months.

Abbreviations: PE-TLIF, percutaneous endoscopic transforaminal lumbar interbody fusion; MRI, magnetic resonance imaging.

Figure 2 A case of MIS-TLIF surgery.

Notes: (A and B) lumbar MRI revealed L4-5 lumbar disc herniation. (C) Frontal and (D) lateral X-ray image represented permanent position after 3 months.

Abbreviations: MIS-TLIF, minimally invasive transforaminal lumbar interbody fusion; MRI, magnetic resonance imaging.

Table 2 Comparison of Serological Markers in Group PE-TLIF and Group MIS-TLIF

Serological Markers	Group PE-TLIF	Group MIS-TLIF	P value
IL-6(pg/mL)
Preoperative	4.37±0.49	4.43±0.49	0.57
3 days	1.13±0.20*	1.23±0.12*	0.0016
CRP (mg/L)
Preoperative	5.00±0.78	4.89±0.67	0.31
3 days	75.89±15.83*	102.71±23.75*	<0.0001
CK (IU/L)
Preoperative	62.55±9.61	60.71±7.05	0.32
3 days	355.01±45.92*	463.41±32.74*	<0.0001

Note: *Compared with preoperative, P < 0.05. Bold values indicate statistical significance. Values are presented as mean ± SD.

Abbreviations: PE-TLIF, percutaneous endoscopic transforaminal lumbar interbody fusion; MIS-TLIF, minimally invasive transforaminal lumbar interbody fusion; IL-6, interleukin‑6; CRP, C-reactive protein; CK, creatine kinase.

Table 3 Comparison of Clinical Outcomes Between PE-TLIF and MIS-TLIF

Clinical Data	Group PE-TLIF	Group MIS-TLIF	P value
VAS back pain			0.025
Preoperative	7.18±0.72	7.36±0.75	0.27
1 week	3.24±0.48*	3.95±0.72*	<0.001
1 month	2.47±0.44*	2.83±0.62*	0.004
3 months	1.76±0.63*	1.66±0.54*	0.47
6 months	1.37±1.56*	1.41±1.25*	0.89
Final follow up	0.65±0.49*	0.76±0.46*	0.29
VAS leg pain			0.57
Preoperative	7.41±0.67	7.62±0.77	0.20
1 week	2.71±0.53*	2.65±0.63*	0.68
1 month	2.13±0.30*	2.23±0.35*	0.15
3 months	1.74±0.56*	1.58±0.53*	0.18
6 months	1.47±1.53*	1.31±1.24*	0.60
Final follow up	0.76±0.48*	0.74±0.42*	0.84
ODI			0.32
Preoperative	41.03±2.19	41.26±1.90	0.61
1 month	32.44±2.79*	32.12±2.40*	0.58
3 months	22.72±1.34*	22.33±1.23*	0.17
6 months	21.38±5.30*	20.44±3.20*	0.33
Final follow up	12.17±1.28*	13.00±3.44*	0.17
JOA			0.69
Preoperative	11.36±1.93	11.05±1.99	0.47
1 month	15.44±0.99*	15.79±1.08*	0.13
3 months	20.23±1.97*	20.51±1.18*	0.43
6 months	21.51±3.32*	22.00±2.75*	0.47
Final follow up	26.56±1.02*	26.90±0.99*	0.14
Operative time (minutes)	146.20±18.25	127.90±7.76	<0.001
Intraoperative blood loss (mL)	48.87±7.14	86.56±8.90	<0.001
Postoperative drainage (mL)	81.23±9.374	150.5±15.12	<0.001
Length of hospital stay (days)	4.79±0.89	7.79±0.74	<0.001
Time to ambulation after surgery (days)	6.54±1.07	15.35±1.98	<0.001
Back to work/ normal lifetime (months)	3.82±0.92	4.43±0.95	0.0043
Complications (%)	12.82%(5/39)	4.65%(2/43)	0.25
Recurrence (%)
3–6 months	7.69%(3/39)	4.65%(2/43)	0.66
CT fusion rates
12 months	89.74%(35/39)	95.35%(41/43)	0.41
Modified MacNab^a
12 months	23:13:2:1	24:15:3:1	0.77

Notes: *Compared with preoperative, P < 0.001. Bold values indicate statistical significance. Values are presented as mean ± SD. ^aExcellent: good: fair: poor.

Abbreviations: PE-TLIF, percutaneous endoscopic transforaminal lumbar interbody fusion; MIS-TLIF, minimally invasive transforaminal lumbar interbody fusion; VAS, visual analog scale; ODI, Oswestry disability index; JOA, Japanese Orthopaedic Association; CT, computed tomography.

Figure 3 Comparison of (A) VAS back pain, (B) VAS leg pain, (C) ODI scores, and (D) JOA scores between the PE-TLIF and MIS-TLIF groups.

Notes: Pre, preoperative; Post 1 W, postoperative 1 week; Post 1 M, postoperative 1 month; Post 3 M, postoperative 3 months; Post 6 M, postoperative 6 months; FFU, Final Follow Up. Data are presented as mean ± SD. **P<0.01, ****P<0.0001 compared with MIS-TLIF group.

Abbreviations: VAS-BP, VAS back pain; VAS-LP, VAS leg pain; ODI, Oswestry disability index; JOA, Japanese Orthopaedic Association; PE-TLIF, percutaneous endoscopic transforaminal lumbar interbody fusion; MIS-TLIF, minimally invasive transformation lumbar interbody fusion.