微创TLIF术治疗腰椎退行性疾病40例疗效观察

Effect of minimally invasive TLIF in the treatment of lumbar degenerative disease

目的探讨微创经椎间孔椎间融合术(TLIF)治疗腰椎退行性疾病的方法及疗效。方法回顾性分析我院2006年7月至2010年1月微创TLIF治疗腰椎间盘突出症40例(微创TLIF组、观察组)随访资料完整的病例,并与同期采用常规开放PLIF治疗的40例患者(常规PLIF组、对照组)进行比较。统计两组手术时间、术中出血量、输血量、术后引流量、VAS评分、ODI评分改善率及术中、术后并发症情况。结果两组患者均获随访12～30个月,平均20个月。微创TLIF组平均手术时间、平均术中出血量、平均输血量、术后平均引流量、VAS评分、ODI评分改善率及术中、术后并发症情况与常规PLIF组比较差异有统计学意义(P<0.05)。结论微创TLIF术治疗腰椎退行性疾病比常规开放PLIF术手术时间短,术中出血量、输血量、术后平均引流量少,临床症状体征改善率高及术中、术后并发症少,适合临床推广应用。

Objective To investigate the application and effect of minimally invasive transforaminal lumbar interbody fusion（TLIF） in the treatment of lumbar degenerative disease. Methods The medical records of 40 patients undergoing minimally invasive TLIF for lumbar disc herniation in our hospital from July 2006 to January 2010 were retrospectively analyzed（minimally invasive TLIF group,the study group） . The data of the study group was compared with that of 40 patients receiving conventional open PLIF（conventional open PLIF group,the control group） ,regarding the operation time,blood loss,blood transfusion,postoperative drainage,VAS and ODI score improvement rate,as well as intraoperative and postoperative complications. Results The two groups of patients were followed up for 12 to 30 months,with an average of 20 months. Results revealed that all the data investigated in the study group showed statistically significant difference with that from the control group（P0.05） . Conclusion Compared with the conventional open PLIF,minimally invasive TLIF has the advantages of shorter operation time,less blood loss,decreased blood transfusion,reduced average postoperative drainage,higher improvement rate of clinical symptoms and signs,as well as less intraoperative and postoperative complications. Therefore,it should be applied and extended clinically.