MIS-TLIF 与 PLIF 治疗单节段腰椎退行性疾病的近期效果比较

摘要

Objective To compare the effect of LUXOR system-assisted minimally invasive sur-gery transforaminal lumbar interbody fusion (MIS-TLIF)with posterior lumbar interbody fusion (PLIF) in treatment for degenerative lumbar diseases. Methods Clinical data of 34 patients with single segment degenerative lumbar disease who underwent MIS-TLIF in our hospital were retrospectively analyzed. The operation time,intraoperative blood loss,postoperative drainage volume,and postoperative bedtime were recorded and compared with those of 30 patients with the same disease who underwent conventional open PLIF during the same period. The back pain visual analogue score (VAS),Oswestry disability in-dex (ODI)score and imaging examination were performed before operation and during follow-up duration for each patient. Results There was no significant difference in the gender,age,clinical diagnosis,le-sion location,VAS and ODI scores before operation between the two groups (P >0.05). The operation time was longer in MIS-TLIF group than in PLIF group (P <0.05);the intraoperative blood loss,postop-erative drainage volume,and postoperative bedtime were lower in MIS-TLIF group than in PLIF group (P <0.01). The back pain VAS scores and ODI scores in the 3rd and 6th month post-operative in MIS-TLIF group were lower than in PLIF group (P < 0.01 ). Radiological follow-up observation revealed good fusion 6 months post-operative in all the patients. Conclusion MIS-TLIF has several advantages o-ver conventional open PLIF,such as less intraoperative blood loss,milder muscle damage,and lighter back pain.%目的：比较传统开放性后路腰椎椎间融合术(PLIF)与微创通道(LUXOR)辅助经椎间孔入路腰椎椎间融合术(MIS-TLIF)治疗单节段退行性腰椎疾病的疗效。方法选择采用 LUXOR 通道辅助 MIS-TLIF 手术治疗的单节段退行性腰椎病变患者34例,回顾性分析手术时间、术中出血量、术后引流量、术后卧床时间和术前及随访时的腰背疼痛视觉模拟评分(VAS)、Oswestry 功能障碍评分(ODI)和影像学检查资料,并与同期行传统开放PLIF 手术的30例患者进行比较。结果2组患者性别、年龄、临床诊断、病变节段、术前腰背痛 VAS 评分和ODI 评分差别均无统计学意义(P >0.05)。MIS-TLIF 组手术时间长于 PLIF 组(P <0.05),术中出血量、术后引流量、术后卧床时间及术后3,6月时的 VAS 评分及 ODI 评分均明显低于 PLIF 组(P <0.01)。术后随访影像学显示,所有患者手术节段均在术后半年内获得良好的节段融合。结论与传统 PLIF 手术比较,MIS-TLIF 治疗单节段腰椎退行性疾病具有出血少、术后恢复快、腰背疼痛轻等优点。