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（three-dimensional exoscope, 3D EX）应用的安全性与可行性。本研究对比了采用手术显微镜（operative microscope, OM）行经椎间孔腰椎椎间融合术（transforaminal lumbar interbody fusion, TLIF）的患者，与采用3D EX实施该手术的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（visual analogue scale, VAS）与Oswestry功能障碍指数（Oswestry disability index, 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（erythrocyte count, RBC）、血红蛋白（hemoglobin, Hb）与血细胞比容（hematocrit, 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（total blood loss, TBL）、显性失血量（visible blood loss, VBL）及隐性失血量（hidden blood loss, HBL）。【研究结果】所有时间点下，两组患者的VAS评分与ODI均无显著统计学差异（均p>0.05）；两组患者的RBC与HBL亦无显著差异（均p>0.05）。在双节段TLIF中，采用3D EX与OM的患者在术后引流量、TBL、Hb及Hct方面存在显著统计学差异（均p<0.05），但单节段TLIF患者中未观察到该差异（均p>0.05）；无论行单节段还是双节段TLIF，两组患者的VBL均存在显著统计学差异（均p<0.05）。【研究结论】本研究数据表明，在TLIF手术中，3D EX可作为OM的合适替代方案。相较于OM，3D EX在双节段TLIF术中减少围手术期失血量方面具有显著优势。