微创通道经椎间孔椎间融合术与传统术式治疗单节段腰椎退行性疾病的疗效比较

Efficacy of minimal invasive posterior transfominal lumbar interbodv fusion and traditional Open tmnsfomminal lumbar interbodv fusion in the treatment of Single leve lumbar degenerative disease

目的探讨微创通道经椎间孔椎间融合术(MIS-TLIF)治疗单节段腰椎退行性疾病的疗效,并与传统开放经椎间孔椎体间融合术(TLIF)比较。方法收治的52例腰椎退行性疾病患者,随机分为对照组和观察组,每组26例,分别采用TLIF治疗和MIS-TLIF治疗。比较两组手术情况,术前、术后视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、日本骨科协会评分(JOA)评分变化及椎间植骨融合率。结果观察组手术术中和术后出血量及住院时间显著低于对照组(P<0.05);术后3个月观察组腰疼和腿痛VAS评分显著低于治疗前和对照组(P<0.05);术后3个月ODI较治疗前均显著降低(P<0.05),JOA评分较治疗前均显著提高(P<0.05),且改善程度显著优于对照组(P<0.05);观察组术后1年椎骨性融合率达到91.43%,显著高于对照组(P<0.05)。结论微创通道经椎间孔椎间融合术治疗单节段腰椎退行性疾病在获得与传统开放经椎间孔椎体间融合术相同的疗效下,植骨融合率更高,出血量、引流量更少,术后恢复更快,综合疗效优于传统方法。

Objective To explore the efficacy of minimally invasive transforaminal lumbar interbody fusion（ MIS- TLIF） treatment of single segment lumbar degenerative disease and compare with the traditional open transforaminal lumbar interbody fusion（ TLIF）. Methods 52 cases of lumbar degenerative disease were selected and randomly divided into the control groups and the observation groups,26 cases in each group and were treated with TLIF and MIS- TLIF treatment. The operation index and the VAS,ODI,JOA score and interbody fusion rate before and after treatment of two groups were compared. Results The intraoperative and postoperative bleeding and hospitalization time in the observation groups were significantly lower than that of the control groups（ P〈 0. 05）. The back pain and leg pain VAS score in the observation group after3 months surgery were significantly lower than that of before treatment and the control groups（ P〈 0. 05）. The ODI score in the observation group after 3 months surgery were significantly lower than that of before treatment and the control groups（ P〈 0. 05）,while JOA score was higher than that of before treatment and the control groups（ P〈 0. 05）. The vertebral fusion rate in the observation groups after one year reached 91. 43%,which was significantly higher than the control group（ P 〈0. 05）. Conclusion The minimally invasive transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disease had the same effect compared with traditional open transforaminal lumbar interbody fusion and had a higher fusion rate,less drainage,faster postoperative recovery. The overall effect was better than the traditional method.