MIS-TLIF下椎间Cage融合术和单纯椎间植骨融合术治疗单节段腰椎间盘突出症疗效对比

Comparative study of MIS-TLIF lower intervertebral Cage fusion and simple intervertebral bone graft fusion in the treatment of single-segment lumbar disc herniation

目的比较微创经椎间孔腰椎椎体间融合(MIS-TLIF)下椎间Cage融合术与单纯椎间植骨融合术治疗单节段腰椎间盘突出症患者的疗效及临床价值。方法收集2012-02-2015-01于我院接受MIS-TLIF术治疗的82例单节段腰椎间盘突出症患者的临床资料,其中采用下椎间Cage融合42例,作为A组,采用单纯椎间植骨融合40例,作为B组,统计两组手术一般情况,比较两组手术效果、术后腰椎功能恢复情况、腰腿痛改善效果及椎间融合状况。结果 (1)A组手术时间长于B组,住院时间短于B组,对比差异有统计学意义(P<0.05)。(2)A组手术并发症发生率略低于B组,其手术优良率略高于B组,但对比差异均无统计学意义(P>0.05)。(3)两组术前VAS、ODI评分比较差异均无统计学意义(P>0.05),术后不同时间,两组上述评分均降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。(4)术后6个月、12个月、24个月,A组椎间隙高度高于B组(P<0.05);术后24个月,A组融合率明显高于B组,对比差异有统计学意义(P<0.05)。结论 MISTLIF椎间Cage融合与单纯椎间骨植骨融合治疗单节段腰椎间突出症疗效相同,但椎间Cage融合可减少椎间隙高度丢失,提高植骨融合率。

Objective To compare the curative effect and clinical value of minimally invasive surgery transforaminal lumbar interbody fusion(MIS-TLIF)lower intervertebral Cage fusion and simple intervertebral bone graft fusion in the treatment of single-segment lumbar disc herniation.Methods The clinical data of 82 patients with single-segment lumbar disc herniation treated by MIS-TLIF in our hospital from February 2012 to January 2015 were collected.42 patients undergoing lower intervertebral Cage fusion were included in group A,while 40 patients undergoing simple intervertebral bone graft fusion were included in group B.The general situation of operation was statistically analyzed.The effects of operation,postoperative lumbar function recovery,relief of pain in waist and lower extremities and status of intervertebral fusion were compared between the two groups.Results①The operation time of group A was longer than that of group B,and the hospital stay was shorter than that of group B(P<0.05).②The incidence rate of complications in group A was slightly lower than that in group B,and the excellent and good rate of operation in group A was slightly higher than that in group B,and the differences were not significant(P>0.05).③There were no statistically significant differences between the two groups in preoperative VAS and ODI scores(P>0.05).The scores in the two groups were decreased at different time points after operation(P<0.05),but there was no significant difference between the two groups(P>0.05).④Six months,12 months and 24 months after operation,the intervertebral height of group A was higher than that of group B(P<0.05).At 24 months after operation,the fusion rate in group A was significantly higher than that in group B(P<0.05).Conclusion Effects of MIS-TLIF intervertebral Cage fusion and simple intervertebral bone graft fusion are similar in the treatment of single-segment lumbar disc herniation,but the intervertebral Cage fusion can reduce the intervertebral height loss and improve the bone graft fusion rate.