改良后路腰椎体间融合术治疗腰椎管狭窄症的临床观察

Clinical Observation of Modified Posterior Lumbar Interbody Fusion in Treatment of Lumbar Spinal Stenosis

目的:研究改良后路腰椎体间融合术(PLIF)治疗腰椎管狭窄症的临床疗效。方法:选取2010年7月到2014年7月我院收治的腰椎管狭窄症患者140例,按照随机数字表法将患者分为研究组和对照组,每组70例。研究组给予改良PLIF治疗,对照组给予传统PLIF治疗,比较两组手术时间、术中出血量、住院时间、术后下地时间,应用视觉模拟评分(VAS)评价术前、术后3个月、术后1年腰痛程度,应用Oswestry生活功能障碍指数(ODI)评分评价患者术前和术后1年的生活功能情况,并比较两组并发症的发生率。结果:两组手术时间、术中出血量比较无统计学意义(P>0.05),研究组住院时间、术后下地时间显著短于对照组,差异具有统计学意义(P<0.05);研究组术后3个月和术后1年VAS评分均显著低于对照组,差异具有统计学意义(P<0.05);研究组术后1年ODI评分显著低于对照组,差异具有统计学意义(P<0.05);研究组术后并发症发生率显著低于对照组,差异具有统计学意义(P<0.05)。结论:改良PLIF治疗腰椎管狭窄症效果较PLIF好,能有效改善疼痛情况和日常生活,降低并发症的发生率。

Objective： To study the clinical effect of modified posterior lumbar interbody fusion in treatment of lumbar spinal stenosis. Methods： A total of 140 patients with lumbar spinal stenosis, who were admitted to Yibin Second People＇s Hospital of Sichuan Province from July 2010 to July 2014, were selected and randomly divided into study group （n=70） and control group （n=70）. The study group was treated with modified PLIF, and the control group was treated with PLIF. The operation time, bleeding volume in operation, hospitalization time and getting out of bed time after operation of the two groups were compared; the degree of lumbago before operation, 3 months and 1 year after operation were evaluated by visual analogue scale （VAS）; the functional status of patients before operation and 1 year after operation were evaluated by Oswestry disability index（ODI） score; and the incidence of complications of the two groups was compared. Results： There were no significance in operation time, bleeding volume in operation between the two groups （P〉0.05）. The hospitalization time and the getting out of bed time of study group were shorter than those of control group, the differences were statistically significant （P〈0.05）. The VAS of study group was significantly lower than that of control group 3 months and 1 years after operation, the differences were statistically significant （P〈0.05）. The ODI score of the study group was significantly lower than that of control group 1 years after operation, the difference was statistically significant（P〈0.05）. The incidence of postoperative complications in the study group was significantly lower than that in the control group, the difference was statistically significant（P〈0.05）. Conclusion： The effect of modified PLIF in the treatment of lumbar spinal stenosis is beteer than PLIF. It can effectively improve pain and daily life of the patients with lumbar spinal stenosis, and reduce the incidence of complication.