MIS-TLIF与W-TLIF治疗单节段腰椎椎管狭窄症的临床效果分析

Clinical Effect Analysis of MIS-TLIF and W-TLIF in the Treatment of Single-segment Lumbar Spinal Stenosis

目的:探讨微创经椎间孔腰椎椎体间融合术(MIS-TLIF)与单切口双侧Wiltse入路的经椎间孔腰椎椎体间融合术(W-TLIF)治疗单节段腰椎椎管狭窄症的临床效果。方法:选取2015年7月1日-2017年7月1日笔者所在医院收治的100例单节段腰椎椎管狭窄患者,根据治疗方式不同将其分为MIS-TLIF和W-TLIF组,每组50例。比较两组术中失血量、手术时间、住院时间、术后ODI、VAS评分及并发症发生情况。结果:MIS-TLIF组手术时间长于W-TLIF组,术中出血量显著少于W-TLIF组,差异均有统计学意义(P<0.05)。两组住院时间比较差异无统计学意义(P>0.05)。术后6周两组ODI及VAS评分比较差异均无统计学意义(P>0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论:与MIS-TLIF相比,W-TLIF手术时间较短,但失血量更多,但是两种方法治疗单节段的腰椎管狭窄症的效果相近,术者可根据自己的经验选择手术方式。

Objective:To investigate the clinical effect of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)and single incision bilateral Wiltse approach transforaminal lumbar interbody fusion(W-TLIF)in the treatment of single-segment lumbar spinal stenosis.Method:A total of 100 patients with single-segment lumbar spinal stenosis admitted in our hospital from July 1st,2015 to July 1st,2017 were selected and divided into the MIS-TLIF group and the W-TLIF group according to different treatment methods,with 50 patients in each group.The intraoperative blood loss,operation time,hospitalization time,postoperative ODI,VAS score and complications were compared between the two groups.Result:The operation time of MIS-TLIF group was longer than that of W-TLIF group,and the intraoperative blood loss was significantly less than that of W-TLIF group,the differences were statistically significant(P<0.05).There was no significant difference in the hospitalization time between the two groups(P>0.05).There were no significant differences in ODI and VAS scores between the two groups 6 weeks after operation(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Compared with MIS-TLIF,the operation time of W-TLIF is shorter,but the blood loss is greater.However,the two methods have similar effects in the treatment of single-segment lumbar spinal stenosis,and the operator can choose the operation method according to his own experience.