Table_1_v1_Clinical comparison of three-dimensional exoscope vs. operative microscope in transforaminal lumbar interbody fusion: A retrospective case-control study.xls

PurposeHere, we sought to determine the safety and feasibility of three-dimensional exoscope (3D EX). We compared data on surgery, complications, postoperative drainage, hematology, and clinical outcomes in the group that underwent transforaminal lumbar interbody fusion (TLIF) using an operative microscope (OM) relative to those treated using 3D EX.
MethodsWe retrospectively reviewed records on 74 patients who underwent one- or two-level TLIF from August 2019 to October 2020. Repeated measures analysis of variance was used to compare pre- and post-operative visual analogue scale (VAS) scores and oswestry disability index (ODI). We used analysis of covariance to compare pre- and post-operative erythrocyte count (RBC), hemoglobin (Hb), and hematocrit (Hct). Independent sample t-tests was used to compare postoperative drainage volume, total blood loss (TBL), visible blood loss (VBL) and hidden blood loss (HBL).
ResultsThere were no significant differences in VAS and ODI scores between the two groups at all time points (all p > 0.05). RBC and HBL did not differ significantly between the two groups (all p > 0.05). There were significant differences in postoperative drainage volume,TBL, Hb, and Hct values when using 3D EX relative to OM in two-level TLIF (all p < 0.05), but not for one-level TLIF (all p > 0.05). The two groups differed significantly with regards to VBL when used for one- or two-level TLIF (all p < 0.05).
ConclusionOur data show that 3D EX is a suitable alternative to OM in TLIF. Relative to OM, 3D EX has important strengths in reducing perioperative bleeding in two-level TLIF.

研究目的：本研究旨在明确三维外视镜（3D EX）的安全性与可行性。本研究对比了接受经椎间孔入路腰椎体间融合术（TLIF）时分别使用手术显微镜（OM）与三维外视镜（3D EX）的两组患者的手术相关数据、并发症情况、术后引流情况、血液学指标及临床结局。
研究方法：本研究回顾性分析了2019年8月至2020年10月间接受单节段或双节段TLIF的74例患者的临床资料。采用重复测量方差分析比较两组患者术前及术后的视觉模拟评分（VAS）与Oswestry功能障碍指数（ODI）；采用协方差分析比较两组患者术前及术后的红细胞计数（RBC）、血红蛋白（Hb）及血细胞比容（Hct）；采用独立样本t检验比较两组患者的术后引流量、总失血量（TBL）、显性失血量（VBL）及隐性失血量（HBL）。
研究结果：两组患者在各时间点的VAS评分与ODI评分均无显著差异（均p>0.05）；两组患者的红细胞计数与隐性失血量亦无显著差异（均p>0.05）。在双节段TLIF中，使用3D EX与OM的患者在术后引流量、总失血量、血红蛋白及血细胞比容方面存在显著差异（均p<0.05），但单节段TLIF中未观察到此类差异（均p>0.05）；无论单节段还是双节段TLIF，两组患者的显性失血量均存在显著差异（均p<0.05）。
研究结论：本研究数据表明，在TLIF术中，三维外视镜（3D EX）可作为手术显微镜（OM）的合适替代方案。与手术显微镜相比，三维外视镜在双节段TLIF术中可有效减少围手术期失血量，具备显著应用优势。