The minimally invasive spinal surgery in the treatment of posterior edge separation

Posterior edge separation of the vertebral body is an uncommon but non-rare orthopedic disease, the traditional treatment is posterior open surgery. Recently, a lot of attempts in minimally invasive treatment of lumbar posterior edge fracture have been made. We set to discover the value of minimally invasive surgery in the treatment of posterior edge separation, we designed this retrospective study.

Eighteen patients (10 males and 8 females) with posterior edge separation were included between September 2015 and May 2019. The mean age of the patients were 49.9 years. Patients that we included were divided into two groups: people in team A were treated with percutaneous endoscopic lumbar discectomy (PELD), while the other group (team B) were carried the minimally invasive spinal surgery-transforaminal lumbar interbody fusion (MISS-TLIF). The intraoperative/postoperative complications and index were recorded respectively. Visual analogue scale (VAS) and Oswestry disability index (ODI) were applied as evaluation parameters to evaluate the effect of the procedure.

The mean operation time and notch length in PELD group were 71 min and 6.8 mm, while these date in the other group were 105 min and 31.2 mm. In PELD group, the blood loss during the operation were 5 mL and the time lying in bed after the surgery 24 h, the data in corresponding group were 101 mL and 96 h. People included in our trial (excluding 1 defaulters) had a mean follow-up of 9 months (range, 3-12 months). The VAS and ODI score before and after the surgery had insignificant difference between the two groups (P>0.05). Compared with the data before the operation, the VAS and ODI score had significantly improved after the surgery in two groups (P<0.05).

The MISS-TLIF and PELD were all effective methods in the treatment of posterior edge separation.