扩张通道下MI-TLIF辅助椎弓根螺钉内固定治疗腰椎退变性侧弯伴椎管狭窄的疗效及腰痛状况分析

Curative effect of MI-TLIF under expansion channel combined with pedicle screw fixation on treatment of patients with lumbar degenerative scoliosis complicated with spinal stenosis

目的探究扩张通道下MI-TLIF辅助椎弓根螺钉内固定在治疗腰椎性退变性侧弯伴椎管狭窄的临床疗效及腰痛状况。方法选择51例腰椎退变性侧弯伴椎管狭窄患者,按入院顺序分为观察组28例和对照组23例。对照组患者采用TLIF配合椎弓根螺钉内固定进行手术治疗,观察组则在扩张通道下采用MI-TLIF辅助椎弓根螺钉内固定方式进行治疗。就2组患者的临床疗效及腰痛状况进行对比性分析。结果观察组的切口长度、术中出血量、术后引流量、术后下地时间、住院时间显著优于对照组,而其手术时间显著长于对照组(P<0.05)。观察组在术后各时间的VAS评分、ODI评分均显著低于对照组(P<0.05)。观察组在术后1年的植骨融合率为92.86%,与对照组86.96%比较无显著差异(P>0.05),术后2组患者均未见严重并发症发生。结论在治疗腰椎性退变性侧弯伴椎管狭窄上,扩张通道下MI-TLIF辅助椎弓根螺钉内固定的临床疗效与传统TLIF相当。

Objective To explore the effect of MI-TLIF under expansion channel combined with pedicle screw fixation on treatment of patients with lumbar degenerative scoliosis complicated with spinal stenosis. Methods A total of 51 patients with lumbar degenerative scoliosis complicated with spinal stenosis were selected and divided into observation group （n = 28 ） and control group （n = 23 ）. The control group was treated with TLIF combined with pedicle screw fixation, and the observa- tion group was treated with MI-TLIF and pedicle screw internal fixation under the expansion channel. Clinical efficacy and low back pain were compared between two groups. Results The incision length, intra-operative blood loss, postoperative drainage volume, postoperative time and hospital stay in the observation group were significantly better than those in the control group, and the operation time was significantly longer than the control group （P 〈 0.05 ）. The VAS score and ODI score of the observation group were significantly lower than those of the control group （P 〈 0.05）. The bone graft fusion rate after one year was 92.86% in the observation group, which was slightly higher than 86.96% in the control group （P 〉 0.05 ）. There were no serious complications in the two groups. Conclusion In the treatment of patients with lumbar degenerative seoliosis complicated with spinalstenosis , the clinical efficacy of MI - TLIF assisted with pedicle screw fixation under expansion channel is equivalent to traditional TLIF.