单侧MIS-TLIF与传统TLIF手术治疗腰椎退行性疾病的疗效对比
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摘要
目的探讨单侧微创TLIF(MIS-TLIF)与传统TLIF手术治疗腰椎退行性疾病的疗效差异。方法自2013-07-2016-02,采用TLIF手术治疗81例腰椎退行性疾病患者,其中34例予以单侧MIS-TLIF(观察组),另47例予以传统TLIF手术(对照组),对两组的相关指标进行对比。结果①手术情况:与对照组相比,观察组的手术时间显著缩短,术中出血量显著减少,差异有统计学意义(P<0.05);②手术疗效:两组末次随访时的VAS评分和ODI指数均较术前显著降低(P<0.05),组间对比无显著性差异(P>0.05);③植骨融合情况:截至末次随访,观察组植骨融合率为91.2%,略低于对照组的97.9%,但组间并无统计学差异(P>0.05)。结论:单侧MIS-TLIF手术治疗腰椎退行性疾病,其手术疗效与传统TLIF手术相近,但手术时间更短、术中出血量显著减少,是一种相对可靠的微创TLIF手术方案。
Objective To explore the difference in the curative effect of unilateral minimally invasive TLIF(MIS-TLIF) and traditional TLIF operation in the treatment of lumbar degenerative diseases. Methods From July 2013 to February 2016, 81 cases of lumbar degenerative disease were treated by TLIF operation. Among them, 34 cases were given unilateral MIS-TLIF(observation group), the other 47 cases were treated by traditional TLIF operation(control group), and the related indicators of two groups were compared. Results(1) Operation: compared with the control group, the operation time of the observation group was significantly shortened, the amount of bleeding was significantly reduced, the differences were statistically significant(P<0.05).(2) Curative effect: at the end of the last follow-up, the VAS score and ODI index in the two groups were significantly decreased(P<0.05), there was no significant difference between the two groups(P>0.05).(3) Bone fusion: at the last follow-up, the fusion rate of the observation group was 91.2%, which was slightly lower than 97.9% in the control group, but there was no significant difference between the two groups(P>0.05). Conclusion Unilateral MIS-TLIF operation is similar to traditional TLIF operation in the treatment of lumbar degenerative diseases, but it has shorter operative time and less intraoperative blood loss.
Objective To explore the difference in the curative effect of unilateral minimally invasive TLIF(MIS-TLIF) and traditional TLIF operation in the treatment of lumbar degenerative diseases. Methods From July 2013 to February 2016, 81 cases of lumbar degenerative disease were treated by TLIF operation. Among them, 34 cases were given unilateral MIS-TLIF(observation group), the other 47 cases were treated by traditional TLIF operation(control group), and the related indicators of two groups were compared. Results(1) Operation: compared with the control group, the operation time of the observation group was significantly shortened, the amount of bleeding was significantly reduced, the differences were statistically significant(P<0.05).(2) Curative effect: at the end of the last follow-up, the VAS score and ODI index in the two groups were significantly decreased(P<0.05), there was no significant difference between the two groups(P>0.05).(3) Bone fusion: at the last follow-up, the fusion rate of the observation group was 91.2%, which was slightly lower than 97.9% in the control group, but there was no significant difference between the two groups(P>0.05). Conclusion Unilateral MIS-TLIF operation is similar to traditional TLIF operation in the treatment of lumbar degenerative diseases, but it has shorter operative time and less intraoperative blood loss.
引文
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[2] Yoo JS, Min SH,Yoon SH,et al. Paraspinal muscle changes of unilateral multilevel minimally invasive transforaminal interbody fusion[J].J Orthop Surg Res,2014,9:130.
[3] Joseph JR, Smith BW, La Marca F,et al. Comparison of complication rates of minimally invasive transforaminal lumbar interbody fusion and lateral lumbar interbody fusion:a systematic review of the literature[J]. Neurosurgical focus,2015,39(4):E4.
[4] Chou D. Considerations when contemplating minimally invasive versus open transforaminal lumbar interbody fusion[J]. World neurosurgery,2015,84(5):1205-1206.
[5]谭健,李平元,欧军,等.单侧椎弓根螺钉固定联合椎间融合术治疗腰椎间盘突出症[J].实用骨科杂志,2015,21(1):5-8.
[6]高中洋,秦杰,康健,等. MIS-TLIF术单侧与双侧内固定临床效果比较的Meta分析[J].中国骨伤,2016,29(10):954-962.
[7] Chen HH, Cheung HH, Wang WK, et al. Biomechanical analysis of unilateral fixation with interbody cages[J]. Spine,2005, 30(4):E92-96.
[8]张文,王兰,施勤,等.腰椎行椎间孔入路椎间融合术固定的有限元分析[J].医用生物力学, 2014, 29(5):405-410.
[9]唐向盛,谭明生,杨峰,等.微创TLIF单侧置钉与传统TLIF双侧置钉的前瞻性对比研究[J].实用骨科杂志,2017,23(5):385-389.