TLIF与PLIF治疗中重度腰椎滑脱症的疗效比较

Comparetive Study of Treatment of Moderate to Severe Spondylolisthesis by TLIF and PLIF

目的:比较单侧经椎间孔椎体间融合术(TLIF)与椎弓根钉内固定后路椎体间植骨融合术(PLIF)治疗中重度腰椎滑脱症的临床疗效。方法:选取本院2011年8月至2013年1月收治的68例中重度腰椎滑脱症患者作为研究对象,按照手术方式的不同分为TLIF组与PLIF组。对比分析两种术式的临床疗效与术后并发症。结果:TLIF组平均手术时间、术中出血量、引流量与术后卧床时间明显低于对照组,差异有统计学意义(P<0.05)。术后6个月,两组患者椎间隙高度均有一定程度的缺失,但TLIF组缺失程度明显低于BLIF组(P<0.05)。且TLIF组的VAS与ODI评分降低程度明显低于BLIF组,表明TLIF组术后患者恢复情况优于BLIF组,差异有统计学意义(P<0.05)。同时,TLIF组术后并发症发生率仅为2.86%,BLIF组术后并发症发生率为21.21%,故TLIF组并发症发生率明显低于BLIF组(P<0.05)。结论:TLIF与BLIF在治疗中重度腰椎滑脱症均有较好的疗效,但TLIF在减小手术创伤,缩短手术时间,促进患者恢复,降低手术并发症等方面具有更好的优势,是一种较为理想的手术方式。

Objective： To investigate the clinical efficacy of moderate to severe spondylolisthesis by transforaminal lumbar interbody fusion（ TLIF） and posterior lumbar interbody fusion（ PLIF）. Method： We studied 68 cases with moderate to severe spondylolisthesis from Aug. 2011 to Jan. 2013 in our hospital,which were divided into TLIF group and PLIF group. Compared the clinical efficacy and the postoperative complications of two groups. Result： The average operation time,bleeding amount,drainage flow,and postoperative bed time of TLIF group was significantly decreased. The intervertebral disc height of the two groups had a certain degree of loss after six months,but the lack of TLIF group was significantly lower than PLIF group（ P〈0.05）. The decreased degree of VAS and ODI score of TLIF group was obviously lower than PLIF group,indicating the TLIF group had postoperative recovery than the PLIF group,the difference was statistically significant（ P〈0. 05）. At the same time,the complication rate of TLIF group was only 2. 86%,while BLIF group was 21.21%,the incidence of complications of TLIF group was lower than that in group BLIF group（ P〈0.05）. Conclusion： TLIF and PLIF has good curative effect in the treatment of moderate to severe spondylolisthesis.However TLIF could lessen surgical trauma,shorten the operation time,promote patients recovery and reduce complications,which is an ideal operation method.