Objective To analyze the clinical effects of lumbar degenerative diseases treated with unilateral fixation and transforaminal lumbar interbody fusion (TLIF) by paramedian approach. Methods 60 patients who suffered from lumbar degenerative diseases admitted to our hospital were selected. All patients were treated with unilateral pedicle screw internal fixation combined with TLIF. The intraoperative blood loss, operation time and length of incision were observed. Visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate the back pain, leg pain, and functional recovery before surgery, 3 months after surgery and at last follow-up. Results All the operations were successful, with the length of incision of (4.3 ± 0.4) cm (3.5~5.2 cm), intraoperative blood loss of (169 ± 73) mL (120 ~340 mL), and operation time of (104 ± 13) min (80 ~130 min). No serious complication was found after surgery, and the VAS scores of back pain and leg pain, and ODI after surgery were significantly lower than those before surgery (P<0.05). Conclusions The therapy of unilateral fixation and transforaminal lumbar interbody fusion (TLIF) by paramedian approach for lumbar degenerative diseases has the advantages of less trauma, less bleeding and faster postoperative recovery, which can help to alleviate back pain, and improve quality of life. Surgical indications must be considered comprehensively to ensure the best clinical outcomes.%目的 探讨旁正中入路单侧固定经椎间孔椎间融合 (TLIF) 治疗腰椎退行性疾病的临床效果. 方法 选取我院2012年1月至2015年1月收治的60例腰椎退行性疾病患者, 均采用旁正中入路单侧椎弓根螺钉内固定TLIF治疗, 观察术中出血量、手术时间、 切口长度等, 采用疼痛VAS评分、 功能障碍指数 (ODI) 于术前、 术后3个月及末次随访对患者腰痛、 腿痛、 功能恢复进行评估. 结果 60例患者均顺利完成手术, 手术切口长度3.5~5.2 cm, 平均 (4.3±0.4) cm; 术中出血量120~340 mL, 平均 (169±73) mL; 手术操作时间80~130 min, 平均 (104± 13) min; 术后未出现严重并发症, 术后腿痛、 腰痛VAS评分和ODI指数明显低于术前 (P<0.05). 结论 在腰椎退行性疾病治疗中, 采用旁正中入路单侧固定椎间融合治疗, 具有创伤小、 出血量少、 术后恢复快等优势, 有利于缓解腰背疼痛, 提高患者生活质量. 需要综合考虑手术适应证, 确保实现最佳的治疗效果.
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