后路微创经椎间孔腰椎椎体间融合术与传统后路开放腰椎椎体间融合术并发症比较分析

摘要

目的：分析微创经椎间孔腰椎椎体间融合术（ MIS-TLIF）与传统后路开放腰椎椎体间融合术（ OPEN-PLIF）术后并发症情况，并探讨分析并发症的特点及防治。方法对行腰椎融合手术患者265例进行回顾性分析，其中140例行OPEN-PLIF，125例行MIS-TLIF，观察记录手术后各项指标及并发症情况，并对结果进行统计学分析。结果 MIS-TLIF组在手术切口长度、术中出血量、术后引流量、术后住院时间等方面明显优于OPEN-PLIF组（ P＜0.05）。 MIS-TLIF组术后出现并发症8例次（6.4％），其中神经根刺激症状1例，伤口感染1例，脑脊液漏1例，泌尿系统疾病1例，消化道系统疾病1例，心肺系统疾病2例，内固定并发症1例；开放PLIF组出现并发症24例次（17.1％），其中神经根刺激症状8例，伤口感染2例，脑脊液漏3例，泌尿系统疾病2例，消化道系统疾病2例，血液系统疾病3例，心肺系统疾病2例，内固定并发症2例。 MIS-TLIF组并发症发生率低于OPEN-PLIF组（ P＜0.05）。结论微创TLIF治疗腰椎退行性疾病具有损伤小、并发症发生率低、术后恢复快等优点，且安全可靠。%Objective To analyse the postoperation complications of minimally invasive transforaminal lum-bar interbody fusion(MIS-TLIF) and traditional open posterior lumbar intervertebral fusion (OPEN-PLIF) retrospec-tively, and to investigate its characteristics and prevention .Methods An analysis was performed on 265 patients who underwent MIS-TLIF(Group MIS-TLIF,125 cases) or PLIF(Group PLIF,140 cases).Postoperative outcomes and complications were recorded and statistically analyzed .Results In the length of the incision , intraoperative bloodloss, postoperative flow and postoperative hospital stay , etc, the MIS-TLIF group was superior to the OPEN-PLIF group(P<0.05).In group MIS-TLIF, postoperation complications included nerve root irritation in 1 cases, wound infection in 1 case, cerebrospinal fluid leakage in 1 case, urinary system diseases in 1 case, digestive system disease in 1 case, cardiopulmonary system diseases in 2 cases, Internal fixation complication in 1 case;In group PLIF,postopera-tion complications included nerve root irritation in 8 cases, wound infection in 2 cases, cerebrospinal fluid leakage in 3 cases, urinary system diseases in 2 cases, digestive system disease in 2 cases, hematological disease in 3 cases, car-diopulmonary system diseases in 2 cases, Internal fixation complication in 2 case.There was significant difference in to-tal complication rate between 2 groups(P<0.05).Conclusion In the treatment of lumbar degenerative disease , MIS-TLIF is safe and effective , and it has the advantages such as less damage , lower complication rates and faster recovery .