New automatic retraction device assisted unilateral TLIF surgery effectively treats single-level lumbar degenerative diseases

Yapeng Sun et al conducted a study to evaluate the clinical efficacy of unilateral wiltse transforaminal lumbar interbody fusion (TLIF) combined with unilateral nail bar system fixation for single-level lumbar degenerative diseases with the assistance of a new automatic retraction device in a retrospective comparative study.

A total of 46 patients with single-level lumbar degenerative diseases from were retrospectively analyzed. Bilateral nail bar fixation with bullet-type fusion cage (control group, 24 patients) and unilateral nail bar fixation on the affected side with kidney-like fusion cage (study group, 22 patients) were performed in TLIF via wiltse intermuscular approach assisted by a new automatic retraction device. The differences in intraoperative blood loss, operative time, intraoperative fluoroscopy time, postoperative drainage, bed rest, VAS score, ODI score, JOA score, serological creatine kinase (CK), the proportion of multifidus atrophy, modified Pfirrmann classification and intervertebral space height of the upper intervertebral disc were compared between the two groups based on clinical and imaging data.

Key findings of the study were:

• Intraoperative bleeding, operative time, and postoperative drainage were significantly lower in study group than control group, and there were no significant differences in bed rest time and intraoperative fluoroscopy time between them.

• There was no statistical difference in Creatine kinase between the study group and the control group at 24 and 48 h postoperatively.

• No statistically significant difference was found in VAS score of low back pain, VAS score of lower limb pain, ODI index, modified Pfirrmann classification of the upper intervertebral disc and intervertebral space height of the upper intervertebral disc between two groups.

• The atrophy ratio of multifidus muscle was significantly lower in the study group.

The authors concluded that – “We designed a novel automatic retraction device to assist unilateral wiltse muscle gap access TLIF surgical fixation for single-level lumbar degenerative diseases with a kidney-like fusion cage to prevent cage subsidence. The application reduced blood loss during surgery and operative time, and showed better protection of back muscle function during lumbar degenerative diseases treatment, with great potential for clinical application.”

Further reading:

Study of single-level lumbar degenerative diseases treated by unilateral wiltse access with unilateral nail rod fixation assisted by a new automatic retraction device

Yapeng Sun, Wei Zhang et al

Journal of Orthopaedic Surgery and Research (2023) 18:66

https://doi.org/10.1186/s13018-022-03474-x