MIS-TLIF椎间Cage融合术治疗单节段腰椎间盘突出症的效果及术后切口深部感染的因素分析

Effect of MIS-TLIF Interbody Cage Fusion on Single-segment Lumbar Disc Herniation and Analysis of Factors of Deep Surgical Site Infections after Operation

目的:分析MIS-TLIF椎间Cage融合术治疗单节段腰椎间盘突出症的效果和影响患者术后切口深部感染发生因素。方法:选择2018年1月-2019年10月绵阳四0四医院收治的206例单节段腰椎间盘突出症患者为研究对象,将其随机分为观察组和对照组,每组103例。两组患者均采用MIS-TLIF术进行治疗,观察组患者采用Cage融合,对照组单纯椎间植骨融合。比较两组手术效果、术后腰椎功能恢复情况、腰腿痛改善效果、椎间融合状况,分析术后切口深部感染的影响因素。结果:两组术中出血量、引流量和术后切口深部感染发生率比较,差异均无统计学意义(P>0.05);观察组手术时间长于对照组,住院时间短于对照组(P<0.05)。观察组优良率显著高于对照组,差异有统计学意义(P<0.05)。术后12个月,观察组ODI、VAS评分均显著低于对照组(P<0.05)。术后6、12个月,观察组椎间隙高度均显著高于对照组(P<0.05);术后12个月,观察组融合率显著高于对照组(P<0.05)。切口深部感染患者与无切口深部感染患者手术时间和切口长度比较,差异均有统计学意义(P<0.05)。手术时间、切口长度是影响患者切口深部感染发生的独立影响因素(P<0.05)。结论:单节段腰椎间盘突出症采用MIS-TLIF椎间Cage融合术治疗具有较好的临床疗效,且手术时间、切口长度是影响患者切口深部感染发生的独立影响因素。

Objective:To analyze the effect of MIS-TLIF intervertebral Cage fusion in the treatment of single-segment lumbar disc herniation and the influencing factors of postoperative deep incision infection in patients.Method:From January 2018 to October 2019,206 patients with single-segment lumbar intervertebral disc herniation who were admitted to Sichuan Mianyang 404 Hospital were selected as the research objects,they were randomly divided into observation group and control group,103 cases in each group.Both groups were treated with MIS-TLIF,the observation group was treated with Cage fusion,and the control group was treated with simple interbody fusion.The operation effect,postoperative recovery of lumbar function,improvement of low back and leg pain,and intervertebral fusion status of the two groups were compared,the influencing factors of deep incision infection were analyzed.Result:There were no significant differences in intraoperative blood loss,drainage volume and incidence of deep incision infection between the two groups (P>0.05);the operation time of observation group was longer than that of control group,and the hospitalization time was shorter than that of control group (P<0.05).The excellent and good rate of observation group was significantly higher than that of control group,the difference was statistically significant (P<0.05).12 months after operation,ODI and VAS scores in the observation group were significantly lower than those in the control group (P<0.05).6 and 12 months after operation,the height of intervertebral space in observation group were significantly higher than those in control group (P<0.05);12 months after operation,the fusion rate of observation group was significantly higher than that of control group (P<0.05).Comparison of operative time and incision length between patients with deep incisional infection and patients without deep incisional infection,the differences were statistically significant (P<0.05).Operative time and incision length were independent factors influencing the occurrence of deep incision infection (P<0.05).Conclusion:The treatment of single-segment lumbar disc herniation with MIS-TLIF intervertebral cage fusion has a high clinical effect,and the operation time and incision length are independent factors that affect the occurrence of deep incision infections in patients.