title: Comparison of biochemical response between the minimally invasive and standard open posterior lumbar interbody fusion.
abstract: BACKGROUND
  The mini-invasive open posterior lumbar fusion procedure (mini PLIF) procedure is an alternative to standard open procedure (open PLIF) and is intended to reduce surgery-related trauma. The measuring of suitable biochemical factors enables objective comparison of the invasiveness of spinal surgery procedures.
  
  
  METHODS
  Prospectively collected data on myoglobin, creatine kinase, interleukin-6, C-reactive protein levels and intensity of low back pain and radicular pain in one-level mini PLIF and open PLIF procedures were analysed. The mini PLIF and the open PLIF groups included 27 and 23 patients, respectively. The collection of blood samples and clinical data were performed preoperatively and on postoperative days 1, 3 and 7. The non-paired t-test was used for statistical evaluation.
  
  
  RESULTS
  We did not found any statistically significant differences of myoglobin and creatine kinase levels between the groups. In the open PLIF group the IL-6 levels were significantly higher than in the mini PLIF group on postoperative day 3. CRP levels showed significant lower stress response in favour of the mini PLIF group on postoperative days 3 and 7. Levels of post-op low back pain on day 3 were significantly lower in mini PLIF group. Also intensity of radicular pain on day 1 and 3 were lower also mini PLIF group.
  
  
  CONCLUSIONS
  The extent of myonecrosis was comparable in both techniques. The analysis of the IL-6 and CRP levels showed significantly lower systemic inflammatory response in mini PLIF technique. The mini PLIF technique provides transiently lower postoperative pain levels.
authors: Department of Neurosurgery, Bata Hospital, Zlín, Czech Republic. Electronic address: petrlinzer@volny.cz.
authors: Petr
authors: P
authors: Linzer
authors: Department of Neurosurgery, Bata Hospital, Zlín, Czech Republic.
authors: Michal
authors: M
authors: Filip
authors: Department of Neurosurgery, Bata Hospital, Zlín, Czech Republic.
authors: Patrik
authors: P
authors: Jurek
authors: Department of Biochemistry, Bata Hospital, Zlín, Czech Republic.
authors: Tomáš
authors: T
authors: Šálek
authors: Department of Neurosurgery, Pavol Josef Šafárik University, Košice, Slovakia.
authors: Miroslav
authors: M
authors: Gajdoš
authors: Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
authors: Jiří
authors: J
authors: Jarkovský
mesh_terms: D002097:C-Reactive Protein; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D017116:Low Back Pain / Q000097:blood* / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009211:Myoglobin / Q000097:blood*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000097:blood* / Q000503:physiopathology; D013123:Spinal Fusion / Q000379:methods*
chemical_list: D015850:Interleukin-6; D009211:Myoglobin; D002097:C-Reactive Protein; D003402:Creatine Kinase
keywords: Creatine kinase; Interleukin-6; Lumbar interbody fusion; Minimally invasive approach; Myoglobin