椎间孔入路椎体间融合术治疗退变性腰椎管狭窄症的临床效果

The therapeutic effect of transforaminal lumbar interbody fusion on patients with degenerative lumbar spinal stenosis

目的探讨椎间孔入路椎体间融合术治疗退变性腰椎管狭窄症的临床效果。方法选择2012年1月至2014年1月在我院行椎间孔入路椎体间融合术治疗的退变性腰椎管狭窄症患者50例,统计患者手术时间、术中出血量及术后并发症发生率,评价其手术安全性。对患者术前、术后3个月及6个月进行VAS评分及腰椎JOA评分并评价其临床疗效。结果患者术中平均手术时间为107±16.4min,患者术中平均出血量为(331±154)ml,术中输血患者3例,术后感染患者2例,无其他术后并发症,手术安全性高。与术前比较,术后3个月及术后6个月患者VAS评分明显降低且JOA评分明显升高(P<0.05),术后6个月98%患者改善率达50%以上,手术疗效较好,患者满意度高。结论椎间孔入路椎体间融合术治疗退变性腰椎管狭窄症的临床疗效好、手术安全性高和患者满意度高,具有较好的临床应用价值。

Objective To explore the clinical therapeutic effect of transforaminal lumbar interbody fusion on patients with degenerative lumbar spinal stenosis. Methods 50 patients with degenerative lumbar spinal stenosis were selected from January 2012 to January 2014 in our hospital and they were all received transforaminal lumbar interbody fusion operation. The safety of transforaminal lumbar interbody fusion operation was analyzed by the operational time, intr- aoperatve blood soss and incidence of the postoperative complications. The clinical therapeutic effect of transforaminal lumbar interbody fusion operation was analyzed by comparisons of VAS scores and JOA scores within preoperation, three months after operation and six months after operation. Results The operative time was 107--q-_ 16.4 minutes and the intraoperatve blood loss was 331-q-154ml. There were 3 patients had intraoperative blood transfusion and 2 patients had postoperative infection. The transforaminal lumbar interbody fusion was safe for patients with degenerative lumbar spinal stenosis. Compared with the pre-operation, the VAS scores were significantly decreased （P〈0.05） and JOA scores were apparently increased （P〈0.05） at three months after operation and six months after operation. 98% patients had improved their situation and had high satisfaction of transforaminal lumbar interbody fusion. Conclusion Transforaminal lumbar interbody fusion operation is not only effective to treat with degenerative lumbar spinal stenosis, but also safe and high satisfaction of patients. It has a good clinical application value.