两种手术方式治疗腰椎间盘突出症的疗效分析  

The analysis of therapeutic effects of two different surgical methods in the treatment of lumbar disc herniation

作　　者：刘艳兵[1] 孙先泽[1] 宫瑞[1] 于金河[1] 候树兵 顾振芳[1] 赵正琦[1] 胡红涛[1] 

机构地区：[1]石家庄市第三医院脊柱骨科,河北石家庄050011

出　　处：《临床骨科杂志》2017年第1期13-16,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较微创经椎间孔腰椎椎体间融合术(MIS-TLIF)与经椎间孔腰椎椎体间融合术(TLIF)治疗腰椎间盘突出症的临床疗效。方法对186例腰椎间盘突出症患者分别采用MIS-TLIF(100例)和TLIF(86例)治疗。比较两组术中出血量、术后引流量、输血率、手术时间、并发症发生率,采用腰、腿痛VAS评分和ODI评分评估患者的恢复情况。结果 178例患者获得随访36个月。手术时间、术中出血量、术后引流量、输血率、术后5 d和3、6、12个月腰痛VAS评分以及ODI评分MIS-TLIF组明显优于TLIF组(P<0.05,P<0.01)。两组术后各时间段腰、腿痛VAS评分、ODI评分与术前比较均明显改善(P<0.05,P<0.01)。结论 MIS-TLIF、TLIF均为治疗腰椎间盘突出症较理想的手术方法,MIS-TLIF组手术时间、术中出血量、术后引流量、术后腰痛改善均优于TLIF组。Objective To investigate the therapeutic effects of minimally invasive transforaminal lumbar interbody fusion（ MIS-TLIF） and transforaminal lumbar interbody fusion（ TLIF） for treatment of lumbar disc herniation. Methods All of 186 patients were divided into MIS-TLIF（ n = 100） and TLIF（ n = 86）. Data were compared between the both groups,including operation time,the blood loss during operation and postoperation,postoperation drainage,the rate of transfusion,complications,VAS and ODI score were used to evaluate the clinical results. Results The 178 patients were followed up for 36 months. Operation time and intraoperative blood loss,postoperation drainage,the rate of blood transfusion,VAS and ODI scores at 5 d and 3,6,12 months after operation,MIS-TLIF group were significantly more improved than TLIF group（ P〈0.05,P〈0.01）. VAS of low back pain,legs and ODI scores of each period,two groups were more improved than the preoperative time（ P〈0.05,P〈0.01）. Conclusions For the lumbar disc herniation,MIS-TLIF and TLIF has similar good clinical outcomes,but MIS-TLIF has the advantage of the blood loss during operation and postoperation,operation time,and postoperative back pain.

关 键 词：腰椎间盘突出症 微创经椎间孔腰椎融合术 经椎间孔腰椎融合术 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]