[Study on feasibility of enhanced recovery after surgery combined with mobile microendoscopic discectomy-transforaminal lumbar interbody fusion in the treatment of lumbar spondylolisthesis].

Objective

To explore the feasibility of enhanced recovery after surgery (ERAS) combined with mobile microendoscopic discectomy-transforaminal lumbar interbody fusion (MMED-TLIF) in the treatment of lumbar spondylolisthesis and its influence on postoperative rehabilitation.

Methods

From October 1 2014 to July 1 2016 , a cohort of 52 patients with lumbar spondylolisthesis who received the program of ERAS-MMED-TLIF were retrospectively reviewed in Department of Minimally Invasive Spine Surgery, Tianjin Hospital.The primary outcomes include the operation time, intraoperative blood loss, length of hospital stay, VAS score (low back pain and leg pain) and Oswestry Disability Index (ODI) at different follow-up time and complication.The height of intervertebral space and fusion rate were also recorded as radiographic indicators.

Results

All cases had an average follow-up of 12 months. The mean operative time was (115±30) min with a mean blood loss of (100±35) ml.Compared with preoperative condition, VAS score of low back pain (6.3±3.3 vs 3.5±2.3, P<0.05), VAS score of leg pain (7.1 ± 4.2 vs 3.1 ± 2.6, P<0.05) and the ODI disability index score (43.5±9.6 vs 20.9±7.3, P<0.05) at the postoperative 24 h were decreased and the difference was statistically significant.The mean hospitalized time were (4.9±1.3) days with mean postoperative hospital stay (2.1±1.2) days.Fusion rate was 92.31% (48/52) at the last follow-up time.

Conclusion

ERAS combined with MMED-TLIF is feasible in the treatment of lumbar spondylolisthesis, which can significantly reduce intraoperative bleeding, shorten the total length of stay and postoperative hospital stay, improve postoperative pain and promote rapid rehabilitation of patients after operation without increasing the operation time and influencing the long-term effect, it can be applied in clinical practice.