显微内窥镜MIS-TLIF在腰椎退行性疾病患者中的价值

The Value of Microendoscope MIS-TLIF in Patients With Degenerative Diseases of the Lumbar Spine

目的探讨显微内窥镜辅助微创经椎间孔腰椎椎体间融合术(minimally invasive transforaminal lumbar interbody fusion,MIS-TLIF)治疗腰椎退行性疾病的临床效果。方法随机将2020年1—12月收治的88例腰椎退行性疾病患者分为两组,对照组44例,采用开放经椎间孔腰椎椎间融合术(open-lumbar-minimally invasive approach,OPEN-TLIF)治疗,观察组44例,采用显微内窥镜辅助微创经椎间孔腰椎椎体间融合术(minimally invasive transforaminal lumbar interbody fusion,MIS-TLIF)治疗,对比两组的治疗效果。结果两组手术相关指标对比差异有统计学意义(P<0.05),末次随访时,观察组植骨融合率与对照组比较差异无统计学意义(P>0.05);术后3 d对比,观察组Oswestey功能障碍指数评分(Oswestry disability index,ODI)、视觉模拟评分(visual analogue score,VAS)均优于对照组,差异有统计学意义(P<0.05);两组患者均无切口感染、神经根损伤等并发症发生,观察组硬膜撕裂率低于对照组,但组间比较差异无统计学意义(P>0.05)。结论显微内窥镜辅助MIS-TLIF在腰椎退行性疾病中的应用效果更理想,可推广使用。

Objective To investigate the clinical effect of microendoscope-assisted minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)in the treatment of lumbar degenerative diseases.Methods A total of 88 patients with lumbar degenerative diseases admitted from January to December 2020 were randomly divided into two groups.The control group was 44 patients who were treated with open-lumbar-minimally invasive approach(OPEN-TLIF),and the observation group was 44 patients who were treated with microscopy endoscope-assisted minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)treatment,the treatment effect of the two groups was compared.Results There were significant differences in the comparison of the two groups of surgical indicators(P<0.05).At the last follow-up,there was no significant difference in the rate of intervertebral fusion between the observation group and the control group(P>0.05);3 days after the operation,the observation group’s Oswestry disability index(ODI)and visual analogue score(VAS)were better than those of the control group,the difference was statistically significant(P<0.05);there were no complications such as incision infection and nerve root injury in the two groups,and the dural tear rate in the observation group was lower than the control group,but there was no significant difference between the groups(P>0.05).Conclusion The application effect of microendoscope-assisted MIS-TLIF in degenerative diseases of the lumbar spine is more ideal and can be promoted.