Abstract 【Objective】To investigate the clinical efficacy of transforaminal lumbar interbody fusion (TLIF) assisted by spinal endoscopy in the treatment of obese patients with lumbar disc herniation (LDH).【Methods】A total of 93 obese patients with LDH admitted to our hospital from February 2020 to May 2022 were selected and divided into the observation group (receiving TLIF treatment assisted by spinal endoscopy, n=47) and the control group (receiving traditional posterior open surgery, n=46) according to different surgical methods. The surgical related indicators, visual analog scale (VAS) scores, lumbar spine function [Japanese Orthopaedic Association (JOA) scores and Oswestry Disability Index (ODI) scores], imaging parameters, collapse rate, fusion rate, and incidence of complications were compared between the two groups. 【Results】The observation group had a longer surgery time than the control group (P<0.05), shorter total hospital stay and first time out of bed after surgery compared to the control group (P<0.05), and less intraoperative bleeding compared to the control group (P<0.05). There was no statistically significant difference in ODI scores, lower limb VAS scores, JOA scores, and lumbar VAS scores between the two groups before surgery, 1 day after surgery, and 12 months after surgery (P>0.05). 12 months after surgery, the displacement distance of the top vertebral center and the Cobb angle of the lumbar coronal plane in both groups were lower than before surgery, and the Cobb angle of the lumbar sagittal plane was higher than before surgery, with statistically significant differences (P<0.05). Moreover, the recovery of the displacement distance of the top vertebral center, Cobb angle of the lumbar coronal plane, and Cobb angle of the lumbar sagittal plane in the observation group was better than that in the control group (P<0.05). The collapse rate of the observation group was significantly lower than that of the control group (P<0.05), and the fusion rate was higher than that of the control group (P<0.05). There was no statistically significant difference in the total incidence of complications between the two groups (P>0.05). 【Conclusion】 Compared with traditional posterior open surgery, TLIF assisted by spinal endoscopy is more effective in treating LDH obese patients, with better improvement in imaging parameters, faster recovery, lower risk of fusion device collapse, and higher fusion rate.
ZHANG Bing,MA Hang. Clinical Effect of Endoscopic Assisted Transforaminal Lumbar Interbody Fusion for the Treatment of Obese Patients with Lumbar Disc Herniation[J]. JOURNAL OF CLINICAL RESEARCH, 2024, 41(9): 1331-1334.
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2024, Vol. 41 
