微创单侧椎弓根经椎间孔腰椎体间融合技术在腰椎融合手术中的应用

Unilateral vesus bilateral minimally invasive transforaminal fixation in lumbar interbody fusion

[目的]研究微创单侧椎弓根经椎间孔腰椎体间融合术(transforaminal lumbar interbody fusion,TLIF)的临床效果,并比较双侧椎弓根TLIF手术的术后疗效和并发症。[方法]随机选取2005年5月～2008年12月行腰椎后路融合手术40例,单侧手术组(A组)16例,其中男6例,女10例,平均年龄51.75岁。双侧手术组(B组)24例,其中男、女各12例,平均51.92岁。使用Oswestry评分,JOA评分,VAPS视觉类比评分对两组患者术前症状评分及术后疗效参数进行比较,并对两组的手术时间、出血量及融合率进行比较。[结果]单侧组与双侧组随访3～6个月,两组术前与术后3个月的Oswestry评分,JOA评分,VAPS视觉类比评分有统计学差异(P<0.05),A组术后的Oswestry评分,JOA评分,VAPS视觉类比评分与B组无统计学差异(P>0.05),两组手术时间有统计学差异,A组少于B组,两组出血量无统计学差异,两组术后3个月的融合率为100%,均无术后并发症。[结论]微创单侧椎弓根与双侧椎弓根TLIF手术均有疗效,无统计学差异。

[Objective]To compare the postoperatively clinical effects and complications between unilateral and bilateral minimally invasive transforaminal lumbar interbody fusion（TLIF）.[Methods]From May 2005 to December 2008,40 cases receviving TLIF technique were randomly divided into 2 groups.Unilateral TLIF was applied in 16 cases in group A,with 6 male,10 female,and average age of 51.75 years.Bilateral TLIF was applied in 24 cases in group B,with 12 male,12 female,and average age of 51.92 years.Pre-operative conditions and post-operative effects were compared between 2 groups with Oswestry disability index,JOA index,and VAPS index.The operation time,blood loss and healing rates were also compared.[Results]All cases were followed up for 36 months.In both of the two groups,ODI,JOA,VAPS indexes showed significant differences between pre-and 3 months post-operation（P〈0.05）.Between group A and B,all postoperative indexes showed no significant difference（P〉0.05）.Blood loss showed no signific...更多ant difference（P〉0.05）.Operation time in group A was shorter than that in group B,with significant difference（P〈0.05）.Healing rate in both two groups were 100%,with no significant difference（P〉0.05）.No postoperative complication was found in two groups.[Conclusion]Unilateral TLIE technique has achieved satisfying postoperative effect compared with bilateral TLIF,with a good prospect in clinical application.