两种TLIF术式治疗单节段腰椎退行性疾病临床对比研究  

Clinical comparative study of two kinds of TLIF scheme in the treatment of patients with single segment lumbar degenerative disease

作　　者：陈敬忠[1] 张东[1] 肖伟[1] 方凯[1] 黄飞[1] Chen Jingzhong Zhang Dong Xiao Wei et al(Department of Orthopedics, the Second Hospital of Neijiang City, Neijiang Sichuan, 641000, China)

机构地区：[1]内江市第二人民医院骨科,四川内江641000

出　　处：《生物骨科材料与临床研究》2017年第4期40-43,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨开放与微创TLIF术式对单节段腰椎退行性疾病患者围手术期临床指标、ODI评分及术后并发症的影响。方法选取我院2011年8月~2014年5月收治单节段腰椎退行性疾病患者共140例,以随机数字表法分为开放组(70例)和微创组(70例),分别采用开放与微创TLIF术式治疗;比较两组患者围手术期临床指标,术前、术后3,12,24个月VAS评分、JOA评分、ODI评分、椎间植骨融合率及术后并发症发生率等。结果两组患者手术用时比较,差异无统计学意义(P>0.05);微创组患者术中出血量、术后出血量及术后首次下地活动时间均显著优于开放组(P<0.05);微创组患者术后3个月VAS评分,JOA评分及ODI评分均显著优于开放组、术前(P<0.05);两组患者术后12个月和24个月VAS评分,JOA评分及ODI评分比较,差异无显著性(P>0.05);微创组患者术后椎间植骨融合率显著高于开放组(P<0.05);两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论微创TLIF术式治疗单节段腰椎退行性疾病患者手术创伤小,术后恢复时间短,可快速缓解腰腿疼痛,改善肢体活动功能,且未增加术后并发症发生几率,价值优于开放TLIF术式。Objective To investigate the effect of two kinds of TLIF scheme including open and minimally invasive on perioperative clinical parameters, ODI score and postoperative complications of patients with single segment lumbar degenerative disease. Methods 140 patients with single segment lumbar degenerative disease were chosen in the period from Aug 2011 to May 2014 in our hospital and randomly divided into two groups including open group （70 patients） with open TLIF scheme and minimally invasive group （70 patients） with minimally invasive TLIF scheme; and the perioperative clinical index, VAS score, JOA score and ODI score before and in 3 months, 12 months 24 months after surgery, interbody fusion rate and postoperative complications incidence after operation of both groups were compared. Results There was no significant difference in operation time between two groups （P〈0.05）. The intraoperative blood loss, postoperative blood loss and the time of postoperative activity for first time of minimally invasive group was significant higher than open group （P〈0.05）. The VAS scores, JOA scores and ODI scores in 3 months after operation of minimally invasive group were significant better than open group and before operation （P〈0.05）. There was no significant difference in the VAS scores, JOA scores and ODI scores in 12 and 24 months after operation between 2 groups （P〈0.05）. The interbody fusion rate after operation of minimally invasive group were significant higher than open group （P〈0.05）. There was no significant difference in the postoperative complications incidence after operation between 2 groups （P〈0.05）. Conclusion Minimally invasive TLIF scheme in the treatment of patients with single segment lumbar degenerative disease possess the advantages including smaller surgical trauma and shorter postoperative recovery time and can efficiently rapidly relieve the pain of leg and waist, improve the limb function, and not increase the risk of complications after operation.

关 键 词：开放 微创 TLIF 腰椎退行性疾病 疗效 安全性 

分 类 号：R687.3[医药卫生—骨科学]