经椎间孔外椎体间融合术与经椎间孔椎体间融合术治疗腰椎退行性病变的病例对照研究  

Case-control study of therapeutic effects betweenextraforaminal lumbar interbody fusion and transforaminal lumbar interbody fusion for the treatment of degenerative disorders of lumbar spine

作　　者：陈旺 朱凌 胡胜利 吉璐宏 严浩 邓昶 CHEN Wang;ZHU Ling;HU Sheng-li;JI Lu-hong;YAN Hao;DENG Chang(Department of Spinal Surgery,Hubei 672 Orthopaedics Hospital of Integrated Chinese&Western Medicine,Wuhan,Hubei 430079,China)

机构地区：[1]湖北六七二中西医结合骨科医院脊柱外科,湖北武汉430079

出　　处：《颈腰痛杂志》2022年第4期473-477,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的比较经椎间孔外椎体间融合术(extraforaminal lumbar interbody fusion,ELIF)与经椎间孔椎体间融合术(transforaminal lumbar interbody fusion,TLIF)治疗腰椎退行性病变的临床疗效。方法收集本院自2018年1月~2019年5月行手术治疗的42例腰椎退行性病变患者临床资料,随机分为ELIF组和TLIF组各21例。分析两组患者的手术时间、术中出血量、术后引流量及术后并发症情况、术前及术后的腰痛VAS评分和ODI指数;对两组患者术前、术后的椎间高度变化和术后椎间融合情况进行评估分析。结果两组患者获随访平均15.2个月(12~25个月)。两组患者手术时间无统计学差异(P>0.05),ELIF组术中出血量及术后引流量少于TLIF组(P<0.05);ELIF组术后1周、3个月的VAS评分及术后1周的ODI指数均优于TLIF组(P<0.05);两组患者术前、术后的椎间高度变化无明显差异(P>0.05);术后1年椎间融合率:ELIF组95.2%(20/21),TLIF组90.4%(19/21),两组无明显差异(P>0.05);两组均未出现严重并发症。结论ELIF切口小,出血少,可保留更多正常结构,患者术后恢复快,临床疗效明确,是一种安全有效的微创化手术方式。Objective To evaluate the clinical outcomes between extraforaminal lumbar interbody fusion(ELIF)and transforaminal lumbar interbody fusion(TLIF)for the treatment of degenerative disorders of lumbar spine.Methods The clinical data of 42 patients with lumbar degenerative diseases who underwent surgery in our hospital from January 2018 to May 2019 were collected and randomly divided into ELIF group and TLIF group,with 21 cases in each group.The operation time,intraoperative bleeding volume,postoperative drainage volume,postoperative complications,VAS score and ODI index of low back pain before and after operation were analyzed.The preoperative and postoperative intervertebral height changes and postoperative intervertebral fusion of the two groups were evaluated and analyzed.Results The patients in the two groups were followed up for an average of 15.2 months(12-25 months).There was no significant difference in the operation time between the two groups(P>0.05).The amount of intraoperative bleeding and postoperative drainage in ELIF group were less than those in TLIF group(P<0.05).The VAS score and ODI index of ELIF group at 1 week and 3 months after operation were better than those of TLIF group(P<0.05).There was no significant difference in intervertebral height between the two groups before and after operation(P>0.05).One year after operation,the intervertebral fusion rate was 95.2%(20/21)in ELIF group,and that was 90.4%(19/21)in TLIF group.There was no significant difference between the two groups(P>0.05).There were no serious complications in both two groups.Conclusion ELIF has advantages of small incision,little bleeding,no destruction of the structure and good recovery,which is one of effective and safe minimally invasive spine surgery for degenerative disorders of lumber spine.

关 键 词：微创 经椎间孔外椎体间融合 经椎间孔椎体间融合 腰椎退行性疾病 

分 类 号：R687.3[医药卫生—骨科学]