单侧经椎间孔入路椎间植骨融合术对慢性下腰痛的疗效分析

Effects of unilateral tansforaminal lumbar interbody fusion on chronic low back pain

目的：评价单侧经椎间孔入路椎间植骨融合术（TLIF）对慢性下腰痛的临床疗效。方法：应用TLIF治疗慢性下腰痛患者39例,分别使用日本骨科学会（JOA）下腰痛评分标准和Oswestry下腰痛功能障碍问卷调查表（ODI评分表）对所选病例在术前1 d和术后6个月进行评分。结果：入选病例随访时间7-34个月,平均21.4个月。JOA评分组术后6个月评分改善率为（74.42±11.96）%,与ODI评分组的（75.17±10.56）%相比,P〉0.05。JOA评分组改善优良率为94.87%,与ODI评分组的92.31%相比,P〉0.05。两种评价方法在患者的术后改善率及改善优良率方面无统计学差异。结论：TLIF手术方式对主要以腰椎不稳症和（或）腰椎间盘突出症所致的慢性下腰痛近期疗效满意,安全可靠。

Objective To evaluate the effects of unilateral transforaminal lumbar interbody fusion（TLIF） on chronic low back pain.Methods Thirty-nine eligible patients who had suffered from chronic low back pain were treated by TLIF.The treatment outcomes were evaluated by using the criteria for low back pain syndrome of Japanese Orthopaedic Association（JOA） and Oswestry low back pain disability questionnaire respectively 1 day prior to surgery and 6 months after operation.Results All eligible cases were followed-up for 7 to 34 months with an average time of 21.4 months.The improvement rate for the JOA group averaged（74.42±11.96）% compared with（75.17±10.56）% for the ODI group（P〉0.05）.The improvement rate in 94.87% patients of the JOA group was better or excellent compared with 92.31% for the ODI group（P〉0.05）.No statistically significant differences were found between the two groups.Conclusion TLIF technique is a safe and effective procedure with satisfactory clinical results for the treatment of chronic low back pain mainly caused by lumbar instability and（or） protrusion of the lumbar intervertebral disc.