微创经椎间孔腰椎椎间融合术与PLIF治疗单节段腰椎间盘突出症的临床疗效比较

Comparison of clinical effect between minimally invasive transforaminal lumber interbody fusion and posterior lumbar interbody fusion in treating single-level lumber disc herniation

目的 比较微创经椎间孔腰椎椎间融合术（MIS-TLIF）与后路腰椎椎间融合术（PLIF）治疗单节段腰椎间盘突出症临床疗效,评价MIS-TLIF的安全性及有效性。方法 选取自2013-06—2015-01诊治且符合纳入标准的56例腰椎间盘突出症进行研究,PLIF组34例,MIS-TLIF组22例。比较2组手术时间,术中出血量,术后引流量,术前及术后1周ODI评分,术前与术后1周腰、腿痛VAS评分。结果 2组切口均一期愈合。56例均获得8~14（11.2±2.3）个月的随访。与PLIF组相比,MIS-TLIF组术中出血量、术后引流量更少,术后1周VAS评分及ODI评分更低,差异有统计学意义（P〈0.05）;但2组手术时间差异无统计学意义（P〉0.05）。2组术后1周腰痛、腿痛VAS评分及ODI评分较术前明显降低,差异有统计学意义（P〈0.05）。结论 采用MIS-TLIF与传统开放PLIF治疗单节段腰椎间盘突出症均能获得理想临床疗效,但是MIS-TLIF在术中减少组织创伤及术后恢复方面明显优于PLIF。

Objective To compare the clinical effect between minimally invasive transforaminal lumbar interbody fusion （MIS-TLIF） and posterior lumbar interbody fusion （PLIF） in the treatment of single-level lumber disc herniation, and to evaluate the safety and reliability of MIS-TLIF. Methods From Jun. 2013 to Jan. 2015, a total of 56 patients with single- level lumber disc herniation were treated with MIS-TLIF in 22 patients and PLIF in 34 patients. The operation time, intraoperative blood loss, postoperative drainage volume, the visual analogue scale （VAS） scores and the Oswestry disability index （ODI） scores were compared between 2 groups. Results The average follow-up duration was （11.2±2.3）months with range of 8-14 months. No difference was found in operation time between 2 groups（P 〉0.05）. The VAS scores and ODI scores in both two group after operation were less than the preoperative ones （P 〈0.05）. The intraoperative blood loss, postoperative drainage volume, the VAS scores and the ODI scores in MIS-TLIF group were significantly lower than those in the PLIF group （P 〈0.05）. Conclusion Both MIS-TLIF and PLIF in the treatment with single-level lumbar interbody could receive a good clinical effect. But MIS-TLIF is significantly better than PLIF in reducing the damage of tissue and promoting the recovery after operation.