MA-OTIF与MIS-TLIF治疗老年腰椎退行性病变的近期疗效的病例对照研究  

Comparative Study on Application of MA-OTIF and MIS-TLIF in the Treatment of Recent Curative Effect of Senile Lumbar Degenerative Disease Cases

作　　者：张春浩[1] 徐斌[1] 滕勇[1] 陈建常[1] 马锐[2] 戎帅[2] 张屹[3] 安伟[1] 

机构地区：[1]兰州军区乌鲁木齐总医院全军骨科中心 脊柱外科病区,新疆乌鲁木齐830000 [2]新疆医科大学研究生学院,新疆乌鲁木齐830000 [3]解放军第四军医大学西京骨科医院,陕西西安710000

出　　处：《现代生物医学进展》2015年第7期1286-1289,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(31360229)

摘　　要：目的:比较小切口开放经椎间孔腰椎椎体间融合术(MA-OTIF)与微创经椎间孔融合术(MIS-TLIF)治疗老年性腰椎退行性病变的近期疗效。方法:收集2010年1月-2013年1月我院收治的老年性腰椎退行性病变患者,根据治疗方式不同,选择行MA-OTIF治疗者作为研究组,行MIS-TLIF者作为对照组,按一定条件以1:1比例进行配对研究,比较两组患者的手术相关指标及术前和术后的视觉模拟评分(VAS)和功能障碍评分(ODI)。结果:本研究共纳入60例患者,均完成至少1年的随访,平均随访时间1.36年。与MIS-TLIF组比较,MA-OTIF组的手术时间明显缩短,X线透视次数显著减少、术中出血量明显增加,差异均有统计学意义(P<0.05),但两组的住院时间比较均无明显统计学差异(P>0.05)。两组术后VAS和ODI评分均较术前显著降低,差异具有统计学意义(P<0.05),但两组术前与术后VAS和ODI评分比较均无显著性差异(P>0.05)。随访期间,两组均未发生神经根损伤、手术部位感染和椎弓根螺钉断裂等不良情况。结论:MA-OTIF与MIS-TLIF治疗老年性腰椎退行性病变近期疗效相似,MA-OTIF兼备OTLIF和MIS-TLIF的优势。Objective： To compare the short-term curative effect ofmini open transfumminal lumbar interbody fusion （MA-OTIF） and minimally invasive transforaminal lumbar interbody fusion （MIS-TLIF） in the treatment of senile lumbar degenerative disease. Methods： Elderly patients with spinal degenerative diseases admitted in our hospital fxom January 2010 to January 2013 admitted were selected. According to the different treatment methods, the patients treated by MA-OTIF were selected as research group, while the patients treated by MIS-TLIF were selected as control group. The operative index, preoperative and postoperative visual analogue scale （VAS） and dys- function score （ODI） scores were compared between two groups. Results： 60 patients completed at least 1 year of follow-up, the mean follow-up period was 1.36 years. Compared with MIS-TLIF group, the MA-OTIF group had significantly shorter operation time, lower times of X-ray and more intreoperative bleeding（P〈0.05）, but no significant difference was found in the hospital stay between two groups （P〉0.05）. The postoperative VAS and ODI scores of both groups were significantly decreased than those before operation （P〈0.05）, but no significant difference was observed in the preoperative and postoperative VAS and ODI score between two groups （P〉0.05）. During the follow-up visit, no nerve root injury, operation site infection and breakage of pedicle screws and other adverse conditions was ob- served in both groups. Conclusion： The recent therapeutic effect of MA-OTIF in the treatment of senile lumbar degeneration was equal to MIS-TLIF, MA-OTIF had the advantages of both MIS-TLIF and OTL1F.

关 键 词：腰椎 退行性病变 小切口开放经椎间孔腰椎椎体间融合术 微创经椎间孔融合术 

分 类 号：R687.32[医药卫生—骨科学]