腰椎管狭窄症患者行微创经椎间孔腰椎间融合术近远期疗效及预后影响因素分析

Analysis of Short-and Long Term Efficacy and Prognostic Factors of Minimally Invasive Transforaminal Lumbar Intervertebral Fusion in Patients with Lumbar Spinal Stenosis

目的:探讨腰椎管狭窄症患者行微创经椎间孔腰椎间融合术近远期疗效及预后影响因素。方法:回顾性分析2020.1-2021.12收治的70例腰椎管狭窄症患者,评价患者的各项指标。将随访结果分为预后良好组(n=52)及预后不良组(n=18),对比其一般临床情况,分析预后影响因素。结果:所有患者术前到术后2年时间ODI、VAS评分均降低,术后2年更明显(P<0.05);术后节段融合率为94.87%,术后并发症总发生率为11.43%;预后组患者合并腰椎滑脱、腰椎管狭窄数量、合并骨质疏松情况对比差异显著且为预后不良的独立影响因素(P<0.05)。结论:腰椎管狭窄症患者行微创经椎间孔腰椎间融合术治疗近远期疗效较优,且术后融合率较高,并发症发生率较低,但依然有部分患者预后较差,需适当调整干预或治疗方案。

Objective:To explore the short-term and long-term efficacy and prognostic factors of minimally invasive lumbar interbody fusion surgery for patients with lumbar spinal stenosis.Methods:Retrospective analysis of 70 patients with lumbar spinal stenosis admitted from January 2020 to December 2021,evaluating various indicators of the patients.Divide the follow-up results into a good prognosis group(n=52)and a poor prognosis group(n=18),compare their general clinical conditions,and analyze the factors affecting prognosis.Results:All patients showed a decrease in ODI and VAS scores from preoperative to 2 years postoperatively,with a more significant decrease observed at 2 years postoperatively(P<0.05);The postoperative segmental fusion rate was 94.87%,and the total incidence of postoperative complications was 11.43%;The number of patients with lumbar spondylolisthesis,lumbar spinal stenosis,and osteoporosis in the prognostic group showed significant differences and were independent factors affecting poor prognosis(P<0.05).Conclusion:Minimally invasive transforaminal lumbar interbody fusion for patients with lumbar spinal stenosis has better short-term and long-term efficacy,with a higher postoperative fusion rate and lower incidence of complications.However,there are still some patients with poor prognosis who need to adjust their intervention or treatment plans appropriately.