微创经椎间孔腰椎融合内固定术与传统后路开放手术治疗腰椎退行性疾病的比较研究

Comparative study of minimally invasive intervertebral foramen lumbar fusion internal fixation and conventional posterior open surgery in the treatment of lumbar degenerative diseases

目的比较微创经椎间孔腰椎融合内固定术(MIS-TLIF)与传统后路开放手术治疗腰椎退行性疾病的临床疗效。方法采用随机数字表法将76例腰椎退行性疾病患者随机分为两组,每组各38例。其中微创组采取MIS-TLIF术,对照组采取TLIF术,比较两组患者的各项手术观察指标以及两组患者术前及术后ODI、VAS评分、融合率及并发症情况。结果微创组患者的手术用时少、切口小、术中出血少,且患者可以早期下床活动,缩短住院时间(P<0.05)。且微创组患者的ODI、VAS评分分别显著低于对照组(P<0.05)。微创组术后12个月的融合率为92.1%(35/38),对照组为81.6%(31/38),两组比较差异不显著(P>0.05)。结论对于腰椎退行性疾病的治疗,微创经椎间孔腰椎融合内固定术较传统后路开放手术具有出血少、疼痛轻、术后功能恢复快、住院时间短等许多优势,值得临床推广和应用。

Objective To compare the clinical effect of minimally invasive intervertebral foramen lumbar fusion internal fixation and conventional posterior open surgery in the treatment of lumbar degenerative disease. Methods A total of 76 patients with lumbar degenerative disease were randomly divided into two groups according to the random number table, with 38 patients in each group. The minimally invasive group was given MIS-TLIF, and the control group was given TLIF. The surgical observation indicators, the ODI, VAS scores before and after the surgery, fusion rate and complications were compared between the two groups. Results The patients in the minimally invasive group had less duration of surgery, smaller incision, less intraoperative bleeding. Patients could get off bed earlier, and thus the length of stay was shortened（P〈0.05）. The ODI and VAS scores in the minimally invasive group were significantly lower than those in the control group（P〈0.05）. The fusion rates 12 months after the surgery were 92.1%（35/38） in the minimally invasive group and 81.6%（31/38） in the control group respectively. There was no significant difference between the two groups （P〉0.05）. Conclusion For the treatment of lumbar degenerative disease, minimally invasive intervertebral fora- men lumbar fusion internal fixation has many advantages of less bleeding, less pain, quick recovery of postoperative function, and Shorter length of stay than those in conventional posterior open surgery, which is worthy of clinical pro- motion and application.