单侧与双侧内固定MIS-TLIF手术治疗腰椎退行性疾病的疗效对比分析

Comparative analysis of unilateral and bilateral internal fixation of MIS-TLIF in the treatment of lumbar degenerative diseases

目的在MIS-TLIF手术治疗腰椎退行性疾病中,探讨单侧与双侧内固定的疗效是否有所差异。方法自2014-03-2015-03,共纳入MIS-TLIF手术治疗的71例腰椎退行性疾病患者,其中,单侧椎弓根钉内固定33例,作为单侧组;双侧固定38例,作为双侧组。对两组患者的相关指标进行对比。结果术后VAS评分、ODI指数的改善程度对比,两组无显著性差异(P>0.05);但与双侧MIS-TLIF手术相比,单侧组的手术时间和住院时间更短、术中出血量更少(P<0.05)。术后9个月时,单侧组融合率为90.9%、双侧组为94.7%,差异无统计学意义(P>0.05);术后12个月时,两组手术椎体均获得椎间融合。两组并发症发生率相比,单侧组为6.1%,与双侧组的10.5%无显著性差异(P>0.05)。结论 MIS-TLIF手术治疗腰椎退行性疾病可取得满意疗效,但与双侧固定相比,单侧MIS-TLIF手术缩短了手术时间和住院时间,降低了术中出血量,微创优势更明显,有利于患者早日康复。

Objective To evaluate the efficacy of unilateral and bilateral internal fixation in the treatment of lumbar degenerative diseases with MIS-TLIF surgery. Methods From March 2014 to March 2015, 71 patients with degenerative lumbar disease who received MIS-TLIF surgical treatment were included in the study. Thirty-three cases received unilateral pedicle screw fixation were selected as unilateral bilateral fixation group. Thirty-eight cases received bilateral internal fixation were selected as the bilateral group. The relative indicators of two groups were compared. Results The improvement of postoperative VAS score, ODI index in two groups had no significant differences（P〈0.05）. Compared with bilateral MIS-TLIF surgery group, the operative time and hospitalization time of unilateral group was shorter, and the intraoperative bleeding was less（P 0.05）. At 9 months after operation, the fusion rate of unilateral group was 90.9%, that of bilateral group was 94.7%, the difference was not statistically significant（P 〉0.05）. After 12 months, patients in the two groups received interbody fusion. The incidence rate of complications in the unilateral group was 6.1%, that of the bilateral group was 10.5%, there was no significant difference between the two groups（P〈0.05）.Conclusion MIS-TLIF in the treatment of lumbar degenerative disease can obtain satisfactory curative effect, but compared with the fixed bilateral, unilateral MIS-TLIF surgery can shorten the operation time and hospitalization time, reduce the amount of bleeding, has obvious advantage of minimally invasion, it is conducive to the rehabilitation of patients.