侧方椎间融合术与后路减压融合术对腰椎退行性疾病疗效的对比观察  

Comparative analysis of the efficacy of lateral lumbar interbody fusion with percutaneous pedicle screw fixation and posterior lumbar interbody fusion for lumbar degenerative disc diseases

作　　者：齐德泰 赵轶波[1] 陆向东[1] 赵斌[1] 赵晓峰[1] Qi Detai;Zhao Yibo;Lu Xiangdong;Zhao Bin;Zhao Xiaofeng(Department of Orthopedics,Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院骨科,太原030001

出　　处：《骨科临床与研究杂志》2025年第1期18-25,共8页Journal Of Clinical Orthopedics And Research

摘　　要：目的比较腰椎侧方椎间融合术(LLIF)与后路椎间融合术(PLIF)治疗腰椎退行性疾病中的临床疗效。方法2021年1月至2023年1月山西医科大学第二医院骨科行LLIF联合经皮椎弓根钉内固定术(PPSF)与PLIF患者共40例。记录手术时间及出血量,对比分析术前术后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、36项简明健康状况调查问卷(SF-36)及并发症等临床指标,使用PACS系统测量术前术后责任节段椎间隙高度、腰椎前凸角度变化及LLIF-PPSF组核磁轴位责任间隙术前术后硬膜囊面积变化。结果所有患者均获得随访,随访时间10~24(15.3±3.4)个月。LLIF-PPSF组患者单节段所需时间为(154.3±20.9)min,PLIF组为(126.4±19.1)min,两组手术时间相比差异有统计学意义(P<0.05)。LLIF-PPSF组出血量为(50.7±13.6)ml,PLIF组为(324.3±12.7)ml;两组相比差异有统计学意义(P<0.05)。两组患者VAS、ODI、SF-36评分术前与末次随访相比差异均有统计学意义(均P<0.05)。术后第1天VAS、ODI、SF-36评分与PLIF组术后第1天相比差异均有统计学意义(均P<0.05)。两组患者椎间隙高度术前术后相比差异有统计学意义(均P<0.05)。术后腰椎椎间隙高度及前凸角度纠正方面,LLIF-PPSF相比PLIF更具优势,两组间相比差异有统计学意义(P<0.05)。结论LLIF-PPSF和PLIF治疗腰椎退行性疾病疗效确切,但LLIF-PPSF具有出血更少、术后恢复更快、保留后纵韧带复合体等优点。Objective To compare the clinical efficacy of lateral lumbar interbody fusion(LLIF)and posterior lumbar interbody fusion(PLIF)for lumbar degenerative disc diseases.Methods Forty patients underwent LLIF combined with percutaneous pedicle screw fixation(LLIF-PPSF)and posterior lumbar interbody fusion(PLIF)in Department of Orthopedics in Second Hospital of Shanxi Medical University from January 2021 to January 2023,were randomly selected.The surgical time and bleeding volume,compare and analyze preoperative and postoperative visual analog scale(VAS),Oswestry disability index(ODI),36 short form health questionnaire(SF-36),and clinical indicators such as complications were recorded.PACS system were used to measure the height of the intervertebral space and changes in lumbar lordosis angle of the responsible segment before and after surgery,as well as the changes in dural sac area before and after magnetic resonance imaging LLIF-PPSF group.All patients were followed up for 10-24(15.3±3.4)months.Results The average time required for a single segment in the LLIF-PPSF group was(154.3±20.9)min;which was(126.4±19.1)min in the PLIF group.The difference in surgical time between the two groups was statistically significant(P<0.05).The amount of bleeding was(50.7±13.6)ml in the LLIF-PPSF group,which was(324.3±12.7)ml in the PLIF group.The difference between the two groups was statistically significant(P<0.05).There was a statistically significant difference in VAS,ODI,and SF-36 scores between the two groups before surgery and at the last follow-up(all P<0.05).There was a statistically significant difference(all P<0.05)in VAS,ODI,and SF-36 score between the LLIF-PPSF group and the PLIF group on the first day after surgery.There was a statistically significant difference in the height of the intervertebral space between the two groups before and after surgery(all P<0.05).LLIF-PPSF has more advantages than PLIF in correcting the height of lumbar intervertebral space and anterior convexity angle after surgery,and the differenc

关 键 词：脊柱融合术 腰椎 腰椎退行性疾病 后方韧带复合体 

分 类 号：R683[医药卫生—骨科学]