一次性可扩张通道辅助下MIS-TLIF与PLIF治疗单节段腰椎退行性疾病的疗效比较  

Comparison of effects of one-time expandable channel-assisted minimally invasive transforaminal fusion and traditional posterior open surgery on single-segment lumbar degenerative diseases

作　　者：贺海怿 毛克亚[2] 李鹏[1] 李想[1] 聂富祥[1] 朱文辉[1] 张鹏飞[1] 张凯[1] HE Hai-yi;MAO Ke-ya;LI Xiang;LI Peng;NIE Fu-xiang;ZHU Wen-hui;ZHANG Peng-fei;ZHANG Kai(Department of Spine,Sanmenxia Centred Hospital,Sanmenxia,Henan 472000,China;不详)

机构地区：[1]三门峡市中心医院脊柱科,河南472000 [2]解放军总医院第一医学中心骨科

出　　处：《中国骨与关节损伤杂志》2020年第7期686-689,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较一次性可扩张通道辅助下微创经椎间孔融合术(MIS-TLIF)与传统后路开放椎体间融合手术(PLIF)治疗单节段腰椎退行性疾病的临床疗效。方法回顾性分析自2015-03—2017-07诊治的80例单节段腰椎退行性疾病,40例采用通道辅助下MIS-TLIF手术治疗(MIS-TLIF组),40例采用PLIF手术治疗(PLIF组)。比较2组手术时间、术中出血量、切口长度、术后引流量、住院时间、并发症情况、椎间融合等级以及术后1周、3个月、6个月疼痛VAS评分、JOA评分、ODI指数。结果 MIS-TLIF组术中出血量、切口长度、术后引流量、住院时间、并发症情况、椎间融合等级较PLIF组优,手术时间较PLIF长,差异有统计学意义(P <0.05)。MIS-TILF组术后1周、3个月、6个月疼痛VAS评分、JOA评分、ODI指数较PILF组优,差异有统计学意义(P <0.05)。结论一次性可扩张通道辅助下MIS-TLIF术治疗单节段腰椎退行性疾病具有创伤小、术中出血量少、住院时间短、并发症发生率低的优点,临床疗效确切,能够显著缓解术后早期腰背部疼痛,具有一定的临床推广价值。Objective To compare the clinical efficacy of one-time expandable channel-assisted minimally invasive transforaminal fusion(MIS-TLIF) and traditional posterior open interbody fusion surgery(PLIF) for single-segment degenerative lumbar disease. Methods A retrospective analysis of 80 cases of single-segment degenerative lumbar degenerative diseases diagnosed and treated from March 2015 to July 2017 was conducted. Forty cases were treated with channel-assisted MIS-TLIF surgery(MIS-TLIF group) while 40 cases were treated with PLIF surgery(PLIF group). The operation time, intraoperative blood loss, incision length, postoperative drainage volume, hospital stay, complications,intervertebral fusion grade and pain VAS score, JOA score,ODI index at 1 week, 3 months, 6 months, after operation were compared. Results The intraoperative blood loss, incision length, postoperative drainage volume, hospital stay, complications and intervertebral fusion grade of the MIS-TLIF group were better than those of the PLIF group, and the operation time was longer than that of the PLIF, the difference was statistically significant(P <0.05). The pain VAS score, JOA score, the ODI index at 1 week, 3 months, 6 months after operation in MIS-TILF group were better than those in PILF group, the difference was statistically significant(P <0.05). Conclusion The one-time expandable channel-assisted MIS-TLIF surgery for the treatment of single-segment lumbar degenerative diseases has the advantages of less trauma, less intraoperative blood loss, shorter hospital stay, and lower incidence of complications. The clinical effect is definite and it can significantly relieve postoperative early low back pain with certain clinical promotion value.

关 键 词：单节段腰椎退行性疾病 经椎间孔椎体间融合术 后路椎间融合内固定术 可扩张通道 微创 

分 类 号：R681.5[医药卫生—骨科学]