Comparative study of modified midline lumbar interbody fusion and modified transforaminal lumbar interbody fusion for the treatment of single-level lumbar degenerative diseases
Abstract Purpose To evaluate the safety and efficacy of modified cortical bone trajectory (MCBT) screw combined with transarticular screw (TASS) fixation (MCBT-TASS) in modified midline lumbar interbody fusion (M-MIDLIF) for single-level lumbar degenerative disease (LDD). Methods We retrospectively...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-025-03100-7 |
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| Summary: | Abstract Purpose To evaluate the safety and efficacy of modified cortical bone trajectory (MCBT) screw combined with transarticular screw (TASS) fixation (MCBT-TASS) in modified midline lumbar interbody fusion (M-MIDLIF) for single-level lumbar degenerative disease (LDD). Methods We retrospectively included 104 patients with L4–5 or L5–S1 single-segment LDD who had indications for decompression, fusion, and internal fixation surgery from 2019 to 2022. They were subsequently divided into M-MIDLIF and modified transforaminal lumbar interbody fusion (M-TLIF) groups according to the surgical approach. Basic demographic, surgical, and radiological data, as well as clinical outcomes (Oswestry Disability Index (ODI) and visual analog scale (VAS) scores), were collected. Results Basic demographic data, fusion rates, postoperative hospital stays, and follow-up times did not significantly differ between the two groups. Compared with those in the M-TLIF group, the intraoperative blood loss (68.57 ± 14.84 mL) and postoperative drainage volume (33.93 ± 9.17 mL) in the M-MIDLIF group were lower (intraoperative blood loss: 171.79 ± 12.78 mL, p < 0.05; postoperative drainage volume: 65.36 ± 10.36, p < 0.05). In the M-MIDLIF group, there was no significant difference in the radiographic recognizable rate (91.07%) or intraoperative visual recognizable rate (87.50%) of internal inverted chevron-shaped (V-shaped) crests. The optimal position screw rates for the MCBT, TASS, and traditional pedicle screw (TPS) methods were 94.64%, 94.64%, and 87.5%, respectively, and the differences were not significant. MCBT technology preserved the integrity of the posterior ligamentous complex (PLC) in 92.85% of patients in the M-MIDLIF group. The facet joint violation (FJV) rate of MCBT screws (3.57%) was lower than that of TPS screws (14.29%). Compared with the M-TLIF group, the M-MIDLIF group presented greater reductions in the ODI and VAS scores for both low back and leg pain at 1 week postoperatively (P < 0.05). However, no statistically significant differences in these scores were observed between the two groups at later time points (p > 0.05). Conclusion M-MIDLIF can achieve decompression, fixation, and fusion via a median incision while preserving the integrity of the posterior ligamentous complex. In the treatment of single-level lumbar degenerative disease, M-MIDLIF has comparatively enhanced minimally invasive advantages over M-TLIF during the perioperative period while maintaining non-inferior clinical safety and efficacy relative to M-TLIF. |
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| ISSN: | 1471-2482 |