PLIF与MIS-TLIF手术治疗老年患者腰椎退行性疾病疗效分析

Therapeutic Effect of PLIF and MIS-TLIF Surgery on Lumbar Degenerative Diseases in Elderly Patients

目的探讨PLIF与MIS-TLIF手术治疗老年患者腰椎退行性疾病疗效。方法选取该院2015年1月—2017年1月收治的80例老年腰椎退行性疾病患者为研究对象,根据手术方法不同分为两组,PLIF组40例患者采用PLIF手术治疗与MISTLIF组40例患者采用MIS-TLIF手术方式。结果 PLIF组患者术中出血量、术后引流量、术后卧床时间、住院时间明显多于MIS-TLIF组,手术时间明显短于MIS-TLIF组,差异有统计学意义(t=8.111 7、15.782 4、19.724 1、11.065 8、7.230 4,P<0.05)。术后两组患者腰椎JOA评分和腰腿痛VAS评分均显著改善,差异有统计学意义(P<0.05);术后3 d、术后3个月MIS-TLIF组患者腰痛VAS评分较PLIF组更低,差异有统计学意义(P<0.05)。两组患者并发症发生率(17.50%vs 10.00%)对比差异无统计学意义(χ~2=2.371 5,P>0.05)。结论 PLIF与MIS-TLIF手术治疗老年患者腰椎退行性疾病疗效肯定,但相对来说,MIS-TLIF术式具备可操作性强、出血量低、引流量少、卧床时间及住院时间短、手术并发症发生率低等优点。

Objective To investigate the efficacy of PLIF and MIS-TLIF in the treatment of lumbar degenerative diseases in elderly patients. Methods Eighty elderly patients with lumbar degenerative diseases admitted to the hospital（January 2015 to January 2017）were enrolled in the study. They were divided into two groups according to different surgical methods. 40 patients in the PLIF group were treated with PLIF surgery and 40 patients in the MIS-TLIF group underwent MIS-TLIF surgery. Results In the PLIF group, in-traoperative blood loss, postoperative drainage, postoperative bed rest, and hospital stay were significantly more than those in the MIS-TLIF group. The operation time was significantly shorter than that in the MIS-TLIF group, and the difference was statistically significant（t=8.111 7, 15.782 4, 19.724 1, 11.065 8, 7.230 4, P〈0.05）. The postoperative lumbar spine JOA score and waist and leg pain VAS scores were significantly improved in the two groups（P〈0.05）. The VS-TLIF group had lower back pain VAS scores than the PLIF group 3 days after surgery and 3 months postoperatively, the difference was statistically significant（ P〈0.05）. There was no statistically significant difference in the incidence of complications between the two groups（17.50% vs 10.00%）（ χ^2=2.371 5, P〈0.05）.Conclusion PLIF and MIS-TLIF are effective in the treatment of lumbar degenerative diseases in elderly patients. However, MIS-TLIF has relatively high operability, low blood loss, low drainage, bed rest and short hospital stay, and low complication of surgery rate.