腰椎后外侧融合术与后路椎体间融合术治疗腰椎滑脱的临床研究

CLINICAL STUDY OF POSTEROLATERAL LUMBAR FUSION AND POSTERIOR LUMBAR INTERBODY FUSION IN TREATING LUMBAR SPONDYLOLISTHESIS

目的研究腰椎后外侧融合术(PLF)与后路椎体间融合术(PLIF)治疗腰椎滑脱的临床效果。方法将2011年1月—2012年12月骨科收治的腰椎滑脱患者纳入研究,随机分为给予后外侧融合术的PLF组、经后路椎体融合术的PLIF组,观察手术相关指标、近期疗效情况及远期疗效情况。结果 1二组患者术中出血量、术后引流量的差异无统计学意义,且PLIF组患者的手术时间低于对照组;2手术后,二组患者腰部疼痛评分低于手术前,椎间隙高度高于手术前,且PLIF组患者的腰部疼痛评分低于PLF组,椎间隙高度高于PLF组;3术后3,6,9,12个月时,PLIF组的ODI评分均低于PLF组。结论经后路椎间植骨融合术(PLIF)能够缩短手术时间、促进临床症状缓解、改善远期机体功能,并取得与后外侧融合术(PLF)相当的手术创伤。

Objective To compare the clinical effect of posterolateral lumbar fusion（PLF） and posterior lumbar interbody fusion（PLIF） in treating lumbar spondylolisthesis. Methods All the patients with lumbar dpondylolisthesis who were enrolled in the department of orthopedics in authors hospital from January 2011 to December 2012 were randomly divided into the PLIF group which was given posterior lumbar interbody fusion and the PLF group which was given posterolateral lumbar fusion. Then operation related index, short- term effect and long - term effect were observed. Results There was no significant difference between the two groups on intraoperative bleeding volume, postoperative drainage volume, and the operation time of PLIF group was shorter than that in the control group. After operation, the back pain score of the two groups was lower than that before operation, the intervertebral space height of two groups were higher than those before operation, back pain score of PLIF group was lower than that of PLF group, the intervertebral space height of PLIF group was higher than those of PLF group. 3, 6, 9, 12 months after operation, ODI score of PLF group was lower than PLF group. Conclusion Posterior lumbar interbody fusion（PLIF） can reduce the operation time, promote the remission of clinical symptoms, improve the longterm organism function and achieve the equal operation trauma with posterior lateral fusion（PLF）.