{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:26:03Z","timestamp":1791044763240,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,11,7]],"date-time":"2018-11-07T00:00:00Z","timestamp":1541548800000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004731","name":"Natural Science Foundation of Zhejiang Province","doi-asserted-by":"publisher","award":["LY17H060006"],"award-info":[{"award-number":["LY17H060006"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare postoperative imaging results, clinical outcomes and complications between the multifidus muscle bundle (MMB) approach and the conventional open (CO) approach in one\u2010level posterior lumbar interbody fusion (PLIF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Based on the inclusion and exclusion criteria, 201 of 351 patients in our hospital were enrolled in this prospective study and underwent MMB\u2010PLIF or CO\u2010PLIF randomly: 111 patients in the MMB\u2010PLIF group and 90 patients in the CO\u2010PLIF group. A total of 100 patients failed to be followed up in the following 7\u20139\u2009years. Therefore, in this study, 52 patients of the MMB group and 49 patients of the CO group were included. We evaluated the differences in terms of multifidus atrophy rate, intervertebral disc height and segmental lordosis restoration of the operation segment, lumbar lordosis restoration, fusion rate, visual analogue scale (VAS) for back and leg pain, Oswestry disability index (ODI), complication rates, and patient satisfaction rates between the two groups. Correlation between multifidus muscle degeneration and the incidence of complications was investigated, and we compared the multifidus muscle degeneration rate between patients with or without intractable back pain or adjacent segment degeneration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in age, sex, body mass index (BMI), diagnosis, segments distribution, and mean follow\u2010up time between the MMB\u2010PLIF group and the CO\u2010PLIF group. In addition, no differences regarding sex, age, or BMI were found between the lost follow\u2010up group and the successful follow\u2010up group. In regard to imaging and clinical evaluation, at the final follow\u2010up, there were significant differences in multifidus atrophy rates (27.0% \u00b1 6.8% <jats:italic>vs<\/jats:italic> 38.7% \u00b1 10.9%), lumbar lordosis restoration (4.6\u00b0 \u00b1 2.5\u00b0 <jats:italic>vs<\/jats:italic> 3.0\u00b0 \u00b1 1.9\u00b0), postoperative VAS for back pain (1.1 \u00b1 0.9 <jats:italic>vs<\/jats:italic> 1.8 \u00b1 1.2), ODI (7.7 \u00b1 5.0 <jats:italic>vs<\/jats:italic> 12.4 \u00b1 6.7), and patient satisfaction rates (86.5% <jats:italic>vs<\/jats:italic> 61.2%) between MMB\u2010PLIF and CO\u2010PLIF groups. However, there were no significant differences in segmental lordosis, intervertebral height restoration, postoperative VAS for leg pain or fusion rate between the two groups. In regards to complications, there were significant differences in the incidence of adjacent segment degeneration (3.8% <jats:italic>vs<\/jats:italic> 14.3%), intractable back pain (3.8% <jats:italic>vs<\/jats:italic> 22.4%), and residual neurological symptoms (5.8% <jats:italic>vs<\/jats:italic> 20.4%) between the two groups (<jats:italic>P<\/jats:italic> &lt; 0.05) at the final follow\u2010up. In addition, patients with adjacent segment degeneration and intractable back pain were observed with more significant multifidus muscle atrophy than those without these two complications (31.9% \u00b1 1.1% <jats:italic>vs<\/jats:italic> 39.6% \u00b1 2.1% and 30.9% \u00b1 1.1% <jats:italic>vs<\/jats:italic> 42.8% \u00b1 2.1%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with CO\u2010PLIF, MMB\u2010PLIF had advantages in relation to protection of the multifidus muscle, better maintenance of lumbar lordosis, reduced lower back pain and ODI score, fewer complications, and a higher patient satisfaction rate. Protection of the multifidus muscle in lumbar surgery is an important aspect of minimally invasive surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12402","type":"journal-article","created":{"date-parts":[[2018,11,7]],"date-time":"2018-11-07T08:04:25Z","timestamp":1541577865000},"page":"296-305","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Prospective Study of Long\u2010term Effect between Multifidus Muscle Bundle and Conventional Open Approach in One\u2010level Posterior Lumbar Interbody Fusion"],"prefix":"10.1111","volume":"10","author":[{"given":"Hai\u2010feng","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Orthopedics Sir Run Run Shaw Hospital, Medical College of Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang\u2010liang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Sir Run Run 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