微创经椎间孔腰椎体间融合术与后路腰椎体间融合术治疗老年退行性腰椎侧凸椎管狭窄的疗效  

The efficacy of minimally invasive transforaminal lumbar interbody fusion and posterior lumbar interbody fusion in the treatment of degenerative lumbar scoliosis with spinal stenosis in elderly

作　　者：马新强 岳海振 蔡军 MA Xinqiang;YUE Haizhen;CAI Jun(Department of Orthopedics,Liaocheng Hospital of Traditional Chinese Medicine,Liaocheng,Shandong,252000,China)

机构地区：[1]聊城市中医医院骨科,山东聊城252000

出　　处：《当代医学》2024年第18期158-161,共4页Contemporary Medicine

摘　　要：目的比较微创经椎间孔腰椎体间融合术(minimally invasive transforaminal lumbar interbody fusion,MIS-TLIF)与后路腰椎体间融合术(posterior lumbar interbody fusion,PLIF)治疗老年退行性腰椎侧凸椎管狭窄的疗效。方法选取2020年4月至2022年4月聊城市中医医院收治的80例老年退行性腰椎侧凸椎管狭窄患者作为研究对象,根据手术方式的不同分为MIS-TLIF组(n=48)与PLIF组(n=32)。MIS-TLIF组采用MIS-TLIF治疗,PLIF组采用PLIF治疗。比较两组治疗效果[腰椎冠状面侧凸Cobb角和矢状面腰前凸(lumbar lordosis,LL)]、治疗前后腰椎功能情况[日本骨科协会(Japanese Orthopaedic Association,JOA)腰椎功能评分]及术后并发症发生率。结果治疗后,两组侧凸Cobb角均小于治疗前,LL均大于治疗前,差异有统计学意义(P<0.05);两组治疗前后侧凸Cobb角、LL比较差异无统计学意义。治疗1周后,两组主观症状、临床体征、日常活动受限度、膀胱功能评分及总分均高于治疗前,且MIS-TLIF组高于PLIF组,差异有统计学意义(P<0.05)。术后1周内,MIS-TLIF组并发症发生率低于PLIF组,差异有统计学意义(P<0.05)。结论MIS-TLIF与PLIF治疗老年退行性腰椎侧凸椎管狭窄均有显著疗效,能有效改善患者侧凸Cobb角、LL,但MIS-TLIF更有利于患者腰椎功能恢复,且术后并发症发生率低,值得临床推广应用。Objective To compare the efficacy of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)and posterior lumbar interbody fusion(PLIF)in the treatment of degenerative lumbar scoliosis with spinal stenosis in elderly.Methods 80 elderly patients with degenera-tive lumbar scoliosis and spinal stenosis treated in Liaocheng Hospital of Traditional Chinese Medicine from April 2020 to April 2022 were selected as the research subjects,they were divided into the MIS-TLIF group(n=48)and the PLIF group(n=32)according to different surgical treatment methods.The MIS-TLIF group was treated with MIS-TLIF,while the PLIF group was treated with PLIF,the treatment effect(coronal scoliosis Cobb angle and lumbar lordosis[LL]),lumbar function(Japanese Orthopaedic Association[JOA]lumbar function score)before and 1 week after treatment,and the incidence of postoperative complications were compared between the two groups.Results After treatment,Cobb angle of scoliosis of the two groups were smaller than before treatment,and LL were larger than before treatment,the differences were statistically significant(P<0.05),and there were no significant differences in Cobb angle of scoliosis and LL between the two groups before and after treatment.After 1 week of treatment,the subjective symptoms,clinical signs,limits of daily activities,bladder function scores and total scores of the two groups were higher than before treatment,and the MIS-TLIF group was higher than the PLIF group,the differences were statistically significant(P<0.05).Within 1 week after surgery,the total incidence of complications in the MIS-TLIF group was lower than that in the PLIF group,the difference was statistically significant(P<0.05).Conclusion Both MIS-TLIF and PLIF have significant efficacy in the treatment of elderly degenerative lumbar scoliosis with spinal stenosis,and it can effectively improve the scoliosis Cobb angle and LL of patients,but MIS-TLIF is more conducive to the recovery of lumbar function,and its incidence of postoperative complications i

关 键 词：微创经椎间孔腰椎体间融合术 后路腰椎体间融合术 退行性腰椎侧凸椎管狭窄 

分 类 号：R687.3[医药卫生—骨科学]