The Quantitative Analysis of Tissue Injury Markers After Mini-Open Lumbar Fusion
- 1 March 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Spine
- Vol. 31 (6), 712-716
- https://doi.org/10.1097/01.brs.0000202533.05906.ea
Abstract
A prospective and comparative analysis of tissue injury after mini-open lumbar fusion and conventional technique. To evaluate the tissue injury quantitatively after mini-open lumbar fusion. The advantages of minimally invasive techniques demonstrated by clinical reports have been a smaller scar, lesser pain, and rapid rehabilitation. It has not been established, however, that the minimally invasive technique has less tissue injury and less systemic response than the conventional spine surgery. Twenty patients who had undergone posterior decompression and the fusion of the L4-L5 segment for spinal stenosis were studied prospectively. Ten patients that had the conventional posterior decompression and posterior lumbar interbody fusion (PLIF) at L4-L5 were enrolled in a control group. The remaining 10 patients who underwent MISS techniques (paramedian mini-open approach using a tubular retractor) were enrolled in a study group. The serum enzymes representing skeletal muscle injury (creatinine kinase and aldolase), pro-inflammatory cytokines (IL-6, IL-8), and anti-inflammatory cytokines (IL-10, IL-1 receptor antagonist) were analyzed with ELISA techniques. They were checked on the day before operation and 1, 3, 7, and 14 days after operation. Serum creatinine kinase and most of the inflammatory cytokines were significantly high in the control group on postoperative days 1 and 3 and returned to the normal level on postoperative day 7. Serum aldolase was significantly high on postoperative day 1, and IL-8 remained elevated until postoperative day 7 in the control group. Mini-open lumbar fusion may significantly contribute to the reduction of muscle injury and systemic inflammatory reactions during the acute postoperative period. This study suggests that mini-open lumbar fusion may also play an important role in preventing medical morbidity after spinal surgery.Keywords
This publication has 31 references indexed in Scilit:
- A Ligamentum Flavum-Preserving Approach to the Lumbar Spinal CanalSpine, 2003
- The Effects of an Interspinous Implant on Intervertebral Disc PressuresSpine, 2003
- The Posterior Decompression and Posterior Lumbar Interbody Fusion Using a Mini-open Technique: New Suggestion of Minimally Invasive Technique A Preliminary ReportJournal of the Korean Orthopaedic Association, 2003
- Pro-inflammatory and Anti-inflammatory Cytokine Increases After Spinal Instrumentation SurgeryJournal of Spinal Disorders & Techniques, 2002
- Sepsis: A New Hypothesis for Pathogenesis of the Disease ProcessSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1997
- Changes in Serum Creatine Phosphokinase MM Isoenzyme After Lumbar Spine SurgerySpine, 1997
- Arthroscopic Discectomy of the Lumbar SpineClinical Orthopaedics and Related Research, 1997
- Interferon Gamma-1b in the Treatment of Compensatory Anti-inflammatory Response SyndromeArchives of Internal Medicine, 1997
- Sir Isaac Newton, sepsis, SIRS, and CARSCritical Care Medicine, 1996
- Microlumbar DiscectomySpine, 1986