经椎间孔入路椎体间融合术对退变性腰椎管狭窄症的临床疗效观察  

Clinical Effect of Transforaminal Lumbar Interbody Fusion in Treatment of Patients with Degenerative Lumbar Spinal Stenosis

作　　者：赵兵[1] 崔易坤[1] 尹振宇[1] 宋晋刚[1] 羊刚毅[1] ZHAO Bing;CUI Yi-kun;YIN Zhen-yu;SONG Jin-gang;YANG Gang-yi(Department of Spinal Surgery, Central Hospital of Mianyang, Mianyang, Sichuan 621000, China)

机构地区：[1]绵阳市中心医院脊柱外科,四川绵阳621000

出　　处：《解放军医药杂志》2019年第3期96-99,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省卫计委普及应用项目(16PJ191)

摘　　要：目的观察经后方入路椎体间融合术(PLIF)与经椎间孔入路椎体间融合术(TLIF)治疗退变性腰椎管狭窄症的临床疗效。方法回顾性分析2015年3月—2017年7月92例退变性腰椎管狭窄症患者的临床资料,根据手术方法的不同分为研究组与对照组,每组46例。研究组给予TLIF,对照组给予PLIF。比较2组的临床疗效、手术相关指标及并发症发生情况,并比较治疗前后疼痛视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)。结果研究组的疗效优良率高于对照组,手术时间和卧床时间较对照组缩短,术中出血量较对照组减少,且并发症发生率低于对照组(P<0.05)。治疗后1、3、6个月,2组的VAS和ODI评分均低于治疗前,且研究组低于对照组(P<0.05)。结论 TLIF治疗退变性腰椎管狭窄症的临床疗效显著,具有创伤小、出血量少、恢复时间短、症状改善显著以及正常活动功能恢复好的优点。Objective To observe clinical effects of posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) in treatment of patients with degenerative lumbar spinal stenosis. Methods Clinical data of 92 patients with degenerative lumbar spinal stenosis admitted during March 2015 and July 2017 was retrospectively analyzed, and the patients were divided into study group and control group ( n =46 for each group) according to different surgical methods. Study group was treated with TLIF, while control group was treated with PLIF. In two groups, clinical efficacy, related surgical indicators and incidence rate of complications were compared, and scores of pain visual analogue scales (VAS) and Oswestry dysfunction index (ODI) before and after treatment were also compared. Results Compared with those in control group, in study group, excellent and good rate of clinical effect was significantly higher, while operative time and bed-rest time were significantly shorter, and values of intraoperative bleeding volume and incidence rate of complications were significantly lower ( P <0.05). After treatment for 1, 3 and 6 months, VAS and ODI scores were significantly lower than those before treatment in two groups, and the scores in study group were significantly lower than those in control group ( P <0.05). Conclusion Clinical effect of TLIF in treatment of patients with degenerative lumbar spinal stenosis is significant, and it has advantages such as little trauma, less bleeding volume, short recovery time, significant symptoms improvement and good recovery of normal activity function.

关 键 词：经后方入路椎体间融合术 经椎间孔入路椎体间融合术 退变性腰椎管狭窄症 

分 类 号：R681.5[医药卫生—骨科学]