摘要
目的回顾性研究经后方入路椎体间融合术(posterior lumbar interbody fusion,PLIF)和切除上、下关节突的经椎间孔入路椎体间融合术(transforaminal lumbar interbody fusion,TLIF)治疗腰椎失稳症的疗效及并发症情况。方法采用PLIF和TLIF治疗2004年1月至2008年1月本院收治的退变性腰椎失稳症患者78例,其中PLIF31例,TLIF47例。比较两组手术时间、术中出血量、平均卧床时间、Nakai评分优良率、融合时间(按Suk标准)及术后并发症发生率。对两组术前及末次随访时的椎间隙高度及椎间孔高度进行对比研究。结果 78例患者均获随访,随访时间1.5～4.5年,平均3.5年。所有患者均获椎间骨性融合。对两组卧床时间、Nakai评分优良率、融合时间、同时间点椎间隙高度和椎间孔高度进行比较,差异无统计学意义(P>0.05);而在手术时间、出血量以及术后并发症发生率方面,两组之间的差异有统计学意义(P<0.05)。两组末次随访时的椎间隙高度和椎间孔高度均较术前有明显改善(P<0.05)。结论 TLIF和PLIF治疗退变性腰椎失稳症效果良好;与PLIF相比,TLIF操作简单,出血量小,并发症少。
Objective To compare the clinical outcome and complications of posterior lumbar interbody fusion（PLIF） and transforaminal lumbar interbody fusion（TLIF） for the treatment of degenerative lumbar instability.Methods From Jan 2004 to Jan 2008,78 patients with degenerative lumbar instability were treated in our hospital,31 cases undertook PLIF and 47 cases undertook TLIF.The differences of surgery time,estimate blood loss,bed rest time,Nakai score,fusion time（according to the Suk method） as well as postoperative complications were evaluated.Disc height and foraminal height of preoperation and the last follow-up between two groups were compared.Results All patients were followed up from 1.5 to 4.5 years with the average of 3.5 years.All patients achieved spinal fusion.There was no significant difference in bed rest time,Nakai score,fusion time,disc height and foraminal height at the same point between two groups（P 0.05）,but in surgery time,estimate blood loss and postoperative complication incidence,the differences were statistically significant（P 0.05）.Disc height and foraminal height at the last follow-up in both groups were improved compared to preoperative results（P 0.05）.Conclusions PLIF and TLIF provides good outcomes in the treatment of degenerative lumbar instability.Compared to PLIF,TLIF has the advantages of simple operation,less blood loss and few complications.
出处
《中国骨科临床与基础研究杂志》
2011年第1期11-17,共7页
Chinese Orthopaedic Journal of Clinical and Basic Research
