MIS-TLIF单侧固定与双边侧固定治疗单节段腰椎退行性疾病的疗效对比

Comparison of the effects of MIS-TLIF unilateral fixation and bilateral fixation in the treatment of single-segment lumbar degenerative diseases

目的对比分析MIS-TLIF单侧固定与双侧固定治疗腰椎退行性疾病的疗效。方法回顾性分析43例行MIS-TLIF手术治疗的单节段腰椎退行性疾病患者资料,根据手术方式分为两组:观察组21例采用单侧固定,对照组22例双侧固定。统计并比较患者围手术期指标及疼痛VAS评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、并发症发生率。结果观察组患者手术时间、术中出血量、术后引流量和住院时间均显著少于对照组,差异有统计学意义(P<0.05)。术后1个月、6个月,观察组患者VAS评分、ODI指数均显著低于对照组,差异具有统计学意义(P<0.05);术后12个月、18个月,两组患者VAS评分、ODI指数差异均无统计学意义(P>0.05)。观察组患者并发症发生率(4.8%)低于对照组(18.18%),但差异无统计学意义(P>0.05)。结论MIS-TLIF单侧固定治疗单节段腰椎退行性疾病能取得与双边侧固定相似的临床效果,且具有手术创伤小、术后恢复快、并发症发生率低等优点,值得应用。

Objective To compare the efficacy of MIS-TLIF unilateral fixation and bilateral fixation in the treatment of lumbar degenerative diseases.Methods The clinical data of 43 patients with single segment lumbar degenerative diseases treated by MIS-TLIF were retrospectively analyzed.According to the operation methods,they were divided into two groups:21 cases in the observation group were fixed unilaterally,and 22 cases in the control group were fixed bilaterally.The perioperative indicators,pain VAS score,Oswestry disability index(ODI)and the incidence of complications were recorded and compared.Results The operation time,intraoperative blood loss,postoperative drainage and hospital stay in the observation group were significantly lower than those in the control group(P<0.05).At 1 and 6 months after operation,the VAS score and ODI index of the observation group were significantly lower than those of the control group(P<0.05).At 12 and 18 months after operation,there were no significant differences in VAS score and ODI index between the two groups(P>0.05).The incidence rate of complications in the observation group(4.8%)was lower than that in the control group(18.18%),but the difference was not statistically significant(P>0.05).Conclusion MIS-TLIF unilateral fixation can achieve similar clinical effect as bilateral fixation in the treatment of single-segment lumbar degenerative diseases,and has the advantages of less surgical trauma,faster postoperative recovery and lower incidence of complications,which is worthy of clinical application.