经椎间孔行椎体间融合术治疗腰椎退行性疾病的临床分析

Clinical Analysis of Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Disease

目的:探讨经椎间孔行椎体间融合术对腰椎退行性疾病的临床疗效。方法:对本院2011年1月-2013年5月经椎间孔行椎体间融合术治疗腰椎退行性疾病的60例患者的临床资料进行回顾性分析,并与同期行腰椎后外侧融合术的65例患者进行比较分析。结果:(1)两组患者术后ODI功能障碍指数、腰腿痛VAS评分均较术前明显降低(P<0.01),而TLIF组患者术后腰痛和腿痛的VAS评分均明显低于PLF组患者(P<0.05)。(2)TLIF组患者术后骨性融合率达100%,明显高于PLF组的86.15%,差异有统计学意义(P<0.05)。(3)两组患者术后的腰椎前凸角和相对椎间隙高度均较术前明显改善,而TLIF组患者的腰椎前凸角和相对椎间隙高度较PLF组均明显增大,差异均有统计学意义(P<0.05)。结论:经椎间孔行椎体间融合术和腰椎后外侧融合术治疗腰椎退行性疾病均有较好的临床疗效,但经椎间孔行椎体间融合术患者其术后腰腿疼痛的缓解程度、融合率以及椎间隙高度的调整均优于腰椎后外侧融合术,因此可将经椎间孔行椎体间融合术作为治疗腰椎退行性疾病的优选手术方案。

Objective：To explore the clinical curative effect of transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disease.Method：The clinical data of 60 patients with lumbar degenerative disease who were treated by transforaminal lumbar interbody fusion in our hospital from January 2011 to May 2013 were retrospectively analyzed.And 65 patients with posterolateral lumbar fusion at the same time were compared and analyzed.Result：（1）The ODI dysfunction index and the VAS scores of waist and leg pain of patients in the two groups postoperative were significantlylower than those of preoperative（P〈0.01）,and the VAS scores of waist and leg pain of patients in the TLIF group postoperative were significantly lower than those of patients in the PLF group（P〈0.05）.（2）The postoperative osseous fusion rate of patients in the TLIF group was 100%,which was obviously higher than 86.15% of patients in the PLF group,the difference was statistically significant（P〈0.05）.（3）The lumbar lordosis angle and relative height of intervertebral disc in the two groups postoperative were significantly improved compared with preoperative,and the lumbar lordosis angle and relative intervertebral disc height in the TLIF group were increased obviously compared with the PLF group,the differences were statistically significant（P〈0.05）.Conclusion：The transforaminal lumbar interbody fusion and posterolateral lumbar fusion have preferable clinical curative effects for patients with lumbar degenerative diseases,but the extent of the waist and leg pain relief,convergence rate and intervertebral height adjustment of patients by the transforaminal lumbar interbody fusion are superior than those of patients by posterolateral lumbar fusion,so will the transforaminal lumbar interbody fusion can be regarded as a optimizing operation scheme for lumbar degenerative disease.