不保留小关节植骨床PLIF术治疗老年脊柱退行性疾病价值研究

The value of nonreserving small arthroplasty bone PLIF for senile spinal degenerative diseases

目的:探讨不保留小关节植骨床后路椎间植骨融合(PLIF)术治疗老年脊柱退行性疾病的价值。方法:选取116例腰椎滑脱患者纳入研究对象,以随机数表法分为观察组与对照组,每组58例。观察组行不保留小关节植骨床的PLIF手术治疗,对照组行传统PLIF手术治疗。对比两组手术时间、术中出血量、术后引流量、术后下床时间、住院时间及手术前后视觉模拟评分(VAS)、JOA下腰疼痛评分、ODI功能障碍指数、椎间隙高度、滑脱角各项指标,另外统计两组患者住院期间并发症发生情况。结果:观察组手术时间、术中出血量显著少于对照组,差异有统计学意义(P<0.05);两组术后不同时点VAS、ODI评分与术前对比显著降低、两组术后不同时点JOA评分与术前对比显著提高,差异有统计学意义(P<0.05),两组术前及术后不同时点VAS、JOA、ODI评分组间对比差异无统计学意义(P>0.05);两组术后椎间隙高度与术前对比显著提高、两组术后滑脱角与术前对比显著降低,差异有统计学意义(P<0.05),两组术前及术后椎间隙高度、滑脱角组间对比差异无统计学意义(P>0.05),观察组并发症总发生率5.17%与对照组8.62%对比差异无统计学意义(P>0.05)。结论:不保留小关节植骨床的PLIF手术与PLIF手术治疗老年腰椎滑脱患者均可取得满意的治疗效果,达到缓解患者疼痛、改善患者腰腿功能的作用,相对之下不保留小关节植骨床的PLIF手术具有手术时间短、术中出血量少的优势。

Objective:To study the value of nonreserving small arthroplasty bone PLIF for senile spinal degenerative diseases.Methods:A total of 116 patients with lumbar spondylolisthesis treated were selected to be included in the study, and divided into the observation group and the control group by the random number table method, with 58 cases in each group.The observation group was treated with PLIF without reservation of small joint bone grafted bed, while the control group was treated with conventional PLIF.The perioperative operation time, intraoperative blood loss, postoperative drainage volume, postoperative bed time, hospitalization time, VAS, JOA score, ODI score, intervertebral space height, and slip Angle were compared between the two groups, and the incidence of complications during the hospitalization of the two groups were also calculated.Results:The operation time and blood loss in the observation group were significantly less than those in the control group ( P <0.05).The VAS and ODI scores at different time points after operation were significantly lower than those before operation, and the JOA scores at different time points after operation were significantly higher than those before operation ( P <0.05).There were no significant differences in the VAS, JOA, and ODI scores between the two groups before and after surgery ( P >0.05).The height of intervertebral space after operation was significantly higher than that before operation, and the slip angle after operation was significantly lower than that before operation ( P <0.05).There was no significant difference in the height of intervertebral space and the angle of spondylolisthesis between the two groups before and after operation ( P >0.05).The total incidence of complications in the observation group was 5.17% and 8.62% in the control group, with no significant difference ( P >0.05).Conclusion:PLIF surgery and PLIF surgery without retaining the small joint bone graftPatients with lumbar spondylolisthesis can achieve satisfactory therapeutic effects, relieve pain and improve the function of the patient's lower back and leg.In contrast, PLIF surgery that does not retain the small joint bone graft has the advantages of short operation time and less intraoperative blood loss.