TLIF与PLIF治疗腰椎退行性疾病的应用研究  

Application study of TLIF and PLIF in the treatment of lumbar degenerative diseases

作　　者：吴贵根 WU Gui-gen(Hejiang County Traditional Chinese Medicine Hospital,Luzhou,Sichuan 646000,China)

机构地区：[1]合江县中医医院,四川泸州646000

出　　处：《颈腰痛杂志》2024年第4期710-713,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨TLIF及PLIF两种手术方式在治疗腰椎退行性疾病中的临床疗效。方法选取2019~2023年在本院骨伤科进行治疗的60例腰椎退行性疾病患者。通过随机数字法分为PLIF组30例,TLIF组30例。TLIF组采用TLIF手术方式,PLIF组采用PLIF手术方式。记录两组患者的住院时间、手术时间、出血量、术后引流量、融合成功率;术前、术后1周、术后第1个月、第3个月的VAS评分、日本骨科协会评估治疗分数(JOA)评分;术前及术后1周的世界卫生组织生活质量简易量表(WHOQOL-BREF)评分。记录术后神经根损伤、感染、内固定失败等并发症的发生率,作统计学分析。结果TLIF组患者的住院时间、手术时间、出血量及术后引流量对比PLIF组均具有明显优势,差异有统计学意义(P<0.05);两组患者术后VAS评分较术前明显降低,术后1周TLIF组评分明显低于PLIF组,差异有统计学意义(P<0.05)。患者术后腰椎功能明显改善,TLIF组术后1周腰椎功能较PLIF组明显改善(P<0.05),两组术后1个月、3个月对比无统计学差异。术后WHOQOL-BREF评分比较,四个维度评分均差异有统计学意义(P<0.05)。TLIF组并发症发生率为10.00%,低于PLIF组的23.33%(P<0.05)。融合率情况对比,TLIF组为90.00%,高于PLIF组的83.33%,但差异无统计学意义。结论TLIF手术在治疗腰椎退变性疾病中具备明显优势,对于快速恢复患者脊柱功能、减轻术后疼痛及避免手术后并发症具有更好的临床效果;并且,在保留椎体稳定性中更具优势。Objective To compare the clinical efficacy of TLIF and PLIF in the treatment of lumbar retirement diseases.Methods 60 patients with lumbar degenerative diseases whoreceived treatment in the department of orthopedics and traumatology of our hospital from 2019 to 2023 were selected.The patients were divided into control group(30 cases)and experimental group(30 cases)by random number method.The TLIF group underwent TLIF surgery,while the PLIF group underwent PLIF surgery.The length of hospital stay,operation time,blood loss,postoperative drainage volume and fusion success rate of the two groups were recorded.VAS score before surgery,1 week after surgery,1 month after surgery,3 months after surgery,and Japanese Orthopaedic Association Evaluation Treatment Score(JOA)score;Preoperative and 1-week postoperative WHOQOL-BREF scores.The incidence of postoperative nerve root injury,infection,failure of internal fixation and other complications were recorded for statistical analysis.Results The length of hospital stay,operation time,amount of blood loss and postoperative drainage volume of patients in the experimental group had obvious advantages compared with the control group,with statistical significance.The postoperative VAS score of patients in the two groups was significantly lower than that before surgery,and the test score of patients in the two groups was significantly lower than that in the control group one week after surgery,with statistical significance.The lumbar function of the patient was significantly improved after surgery.Compared with the control group,the lumbar function of the experimental group was significantly improved 1 week after surgery,and there was no statistical difference 1 month and 3 months after surgery.The difference of WHOQOL-BREF score was statistically significant.The complication rate of TLIF group was 10.00%,which was lower than that of PLIF group(23.33%).The fusion rate of TLIF group was 90.00%,higher than that of PLIF group(83.33%),and the difference was not statistically significan

关 键 词：腰椎退行性疾病 经椎间孔椎体间融合术 经后路椎体间融合术 

分 类 号：R681.5[医药卫生—骨科学]