极外侧路径下椎体间融合术与传统开放后路椎体间融合术治疗椎间盘突出的效果比较  

Perioperative efficacy of extreme lateral interbody fusion versus traditional open posterior interbody fusion for disc herniation

作　　者：田爱现 马剑雄[1] 马信龙[1] 李岩 TIAN Ai-xian;MA Jian-xiong;MA Xin-long(Institute of Orthopedics,Tianjin Hospital Tianjin Hospital of Tianjin University,Tianjin 300020,China)

机构地区：[1]天津市天津医院(天津大学天津医院)骨科研究所,天津300020

出　　处：《中国中西医结合外科杂志》2023年第3期317-321,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：国自然基金(81871777);天津市中医药重点领域科技项目(2017008);天津市卫健委基金,科技人才培育项目(RC20204);天津市骨科研究所基金(2019TJGYSKY03)。

摘　　要：目的:比较极外侧路径下椎体间融合术(XLIF)与传统开放后路椎体间融合术(PLIF)对椎间盘突出围术期的治疗效果。方法:收集2020年3月—2021年12月在我院接受脊柱手术治疗的患者100例,其中50例行XLIF治疗术(XLIF组),50行PLIF治疗术(PLIF组),术后随访至少90 d,测量并比较两组的VAS评分、塞来昔布使用量、血清肌酸激酶(CK)活性、白细胞(WBC)计数和C反应蛋白(CRP)水平。结果:在术后第1、4、7天,以及出院时和术后第90天,两组VAS评分比较差异无统计学意义(P>0.05);PLIF组与XLIF组塞来昔布消耗量在术后第1、4、7天比较均无统计学差异(P>0.05);在术前,XLIF组和PLIF组血清CK活性比较无统计学差异(P=0.646);术后第1、4、7天,XLIF组血清CK活性低于PLIF组,有统计学差异(P<0.05),但术后第90天时,两组血清CK活性比较无显著性差异(P=0.244);在术前,XLIF组和PLIF组血清WBC计数和C反应蛋白水平比较均无统计学差异(P>0.05),术后第1、4、7天,XLIF组血清白细胞计数和C反应蛋白水平均低于PLIF组,有统计学差异(P<0.05),但术后第90天时,两组血清白细胞计数和C反应蛋白水平比较均无统计学差异(P>0.05)。结论:与开放式PLIF手术相比,XLIF手术有利于减少肌肉损伤,从而更早地恢复日常活动,并减少术后下腰痛的复发率。Objective To compare the perioperative outcomes of extreme lateral interbody fusion(XLIF)and open posterior interbody fusion(PLIF)in the treatment of lumbar disc herniation.Methods A total of 100 patients who underwent spinal surgery in our hospital from March 2020 to December 2021 were collected,including 50 patients treated with XLIF(XLIF group)and 50 patients treated with PLIF(PLIF group).The patients were followed up for at least 90 days.The VAS score,dosage of celecoxib,serum creatine kinase(CK)activity,plasma white blood cell(WBC)count and C-reactive protein(CRP)level were measured and compared between the two groups.Results There was no statistically significant difference in VAS scores between the two groups at 1,4,7 days after operation,at discharge and 90 days after operation(P>0.05).There was no significant difference in celecoxib consumption between PLIF group and XLIF group on the 1st,4th and 7th day after operation between the XLIF group and the PLIF group(P>0.05).On the fourth postoperative day,there was no significant difference in VAS score at 7 days,at discharge and 90 days after operation.There was no significant difference in celecoxib consumption between PLIF group and XLIF group on the 1st,4th and 7th day after operation(P>0.05).There was no significant difference in serum CK activity between the XLIF group and the PLIF group before operation(P=0.646).The serum CK activity in the XLIF group was significantly lower than that in the PLIF group on the 1st,4th and 7th day after operation(P<0.05),but there was no significant difference between the two groups on the 90th day after operation(P=0.244).There was no significant difference in serum WBC count and C-reactive protein level between XLIF group and PLIF group before operation(P>0.05).On the 1st,4th and 7th day after operation,the serum WBC count and C-reactive protein level in XLIF group were lower than those in PLIF group(P<0.05).There was no significant difference in serum white blood cell count and C-reactive protein level between the two

关 键 词：腰椎退行性滑脱 极外侧椎间融合 微创手术 肌肉损伤 下腰痛 

分 类 号：R68[医药卫生—骨科学]