PLF与TLIF手术治疗腰椎不稳症的疗效比较  

Study on outcome of transforaminal lumbar interbody fusion versus posterolateral fusion with pedicle screw system for lumbar spinal instability

作　　者：秦入结[1] 李垠[1] 宋波[1] 史东平[1] 于明[1] 

机构地区：[1]江苏省连云港市第一人民医院,江苏连云港222002

出　　处：《中国现代医学杂志》2008年第18期2719-2721,2724,共4页China Journal of Modern Medicine

基　　金：江苏连云港市卫生局科研项目(No:06005)

摘　　要：目的对比研究用腰椎后外侧融合术(PLF)与经椎间孔椎体间融合术(TLIF)治疗腰椎不稳症的临床疗效。方法45例均行减压短节段椎弓根钉系统固定,TLIF组26例,PLF组19例。比较术中出血量、手术时间、手术前后的椎间高度、融合率、JOA改善率等指标,综合判断近期疗效。结果经随访9～18个月,平均12.2个月。两组手术时间、出血量比较,P<0.05;两组椎间高度重建、骨融合率、并发症发生率比较P<0.05,两组JOA疗效改善率比较P>0.05。结论PLF手术与TLIF手术均是治疗腰椎不稳症的有效术式,TLIF手术时间较长,出血量较大,但骨融合率高、并发症极少。[Objective] To evaluate the outcome of posterolateral fusion （PLF） versus unilateral transforaminal lumbar interbody fusion （TLIF） in treatment of lumbar spinal instability. [Method] There were 45 cases in the seties, 26 cases in TLIF group, and 19 cases in PLF group. All patients were conducted with decompression of spinal canal and short segment pedicle fixation. We compared the operate time, operate hemorrhage, the intervertebral height of preoperation and postoperation, the bone fusion rate, the change of JOA scoring and their complications between two groups. And judge the short period effect. [Result] The follow-up period was 9-18 months, the average was 12.2 months. There was much difference of the average operate time and operate hemorrhage between both groups （P 〈0.05）. There was much difference of reconstructed interbody height between both groups, of the bone fusion rate, of the occurred complications rate both groups （P 〈0.05）. There was no significant difference of clinical outcome based on JOA scoring system. [Conclusion] Both PLF and TLIF operation were all effective to treat lumbar spinal instability. Comparing with PLF procedure, the characteristic of TLIF need longer operative time, more hemorrhage, but it shows a higher rate of bone fusion, a fewer rate of complications.

关 键 词：椎间孔入路 后外侧融合 椎体间融合 腰椎不稳 

分 类 号：R687.3[医药卫生—骨科学]