Quadrant通道下MIS-TLIF治疗腰椎退行性疾病的疗效分析

Curative effect of minimally invasive transforaminal lumbar interbody fusion through Quadrant channel for treatment of lumbar degenerative diseases

目的比较Quadrant可扩张通道微创经椎间孔入路腰椎椎体间融合术(MIS-TLIF)与经椎间孔入路腰椎椎体间融合术(TLIF)治疗腰椎退行性疾病的临床疗效。方法纳入自2014-04—2016-04诊治的47例腰椎退行性疾病,采用Quadrant可扩张通道MIS-TLIF治疗26例(观察组),采用传统开放TLIF治疗21例(对照组)。比较2组手术时间、术中失血量、术后引流量,术后1、3、6、12个月VAS评分、JOA评分、ODI指数。结果 47例均顺利完成手术,与对照组相比,观察组手术时间更短,术中出血量及术后引流量更少,差异有统计学意义(P<0.05)。所有患者均获得12个月以上随访,对照组随访时间平均16.8个月,观察组随访时间平均17.2个月。观察组术后1、3个月VAS评分、JOA评分、ODI指数优于对照组,差异有统计学意义(P<0.05);但2组术后6、12个月VAS评分、JOA评分、ODI指数比较差异无统计学意义(P>0.05)。结论 Quadrant通道下MIS-TLIF治疗腰椎退行性疾病的疗效肯定,与传统TLIF相比,术后早期疼痛缓解明显,有利于早期功能康复锻炼。

Objective To compare the curative effect of minimally invasive transforaminal lumbar interbody fusion （MIS- TLIF） and transforaminal lumbar interbody fusion（TLIF） for treatment of lumbar degenerative disease. Methods Fourty-seven patients with the lumbar degenerative diseases from April 2014 to April 2016 were included. MIS-TLIF surgery though Quadrant channel were carried out in 26 cases （observation group）, while another 21 cases received TLIF surgery （control group）. The operation time, intraoperatve blood loss, postoperative drainage volume, and VAS score, JOA score, ODI index at 1, 3, 6, 12 months after operation in the two groups were compared. Results Fourty-seven cases underwent the surgery successfully. The operation time, intraoperatve blood loss, postoperative drainage volume in observation group were less than that in control group, the difference was statistically significant （P 〈0.05）. All patients received more than 12 months follow- up. The control group average follow-up time was 16.8 months while observation group average follow-up time was 17.2 months. The VAS scores, JOA scores and ODI index at 1, 3 months after surgery were improved in observation group, as compared with that of control group （P 〈0.05）; but there were no statistically significantly differences in VAS scores, JOA scores and ODI index 6, 12 months after operation between two groups （P 〉0.05）. Conclusion MIS-TLIF is superior than the traditional open TLIF with obvious advantages, which is beneficial to early function exercises and postoperative rehabilitation.