通道下微创经椎间孔腰椎椎体间融合术与开放性后路腰椎椎体间融合术治疗单节段腰椎管狭窄症的临床疗效比较(1)
【摘要】目的：比较通道下微创经椎间孔腰椎椎体间融合术(minimally invasive transforaminal lumbar interbody fusion，MIS-TILF)与开放性后路腰椎椎体间融合术(posterior lumbar interbody fusion，PLIF)治疗单节段腰椎管狭窄症的临床疗效。方法：对2012年6月至2016年6月在我院收治的145例单节段椎管狭窄症患者回顾性分析，比较两术式之间手术时间、术中出血量、术后同时间血肌酸激酶水平(CK)、术前术后视觉评分(visual analogue scale，VAS)、术前术后oswestry功能障碍指数(oswestry disability index，ODI)、术后融合率，分析两术式的临床疗效。结果：MIS-TLIF组与PLIF组患者性别、年龄、病程、术前VAS、ODI差异无统计学意义。MIS-TLIF组术中出血量少于PLIF组，手术时间大于PLIF组。MIS-TLIF组患者CK水平、VAS、ODI术后1天、3天、1周优于PLIF组。术后2周CK水平、VAS、ODI差异无统计学意义。两组患者术后3月VAS、ODI、融合率差异无统计学意义。结论：MIS-TLIF技术具有出血少、椎旁肌损伤小等优点，是治疗单节段腰椎管狭窄症较为理想的术式。
【关键词】通道下微创经椎间孔腰椎椎体间融合术;腰椎管狭窄症;回顾性临床对照研究
【中图分类号】R969.4 【文献标识码】B 【文章编号】1672-3783(2018)11-0206-01
【Abstract】Objective：
To compare the minimally invasive transforaminal lumbar interbody fusion(MIS-TILF)with open posterior lumbar interbody fusion(PLIF) for treatment of single segment lumbar spinal stenosis. Methods： In 145 cases of single segment lumbar spinal stenosis were retrospectively analyzed from June 2012 to June 2016 in our hospital. Operation time， intraoperative blood loss， serum creatine kinase level(CK) at the same time after operation， preoperative and postoperative visual analogue scale(VAS)， preoperative and postoperative oswestry disability index(ODI)， fusion rate as the observation indexes. Compare the clinical efficacy of MIS-TILF and PLIF with reference to the above indexes. Results： There was no significant difference in gender， age， course of disease， VAS and ODI between the MIS-TLIF group and the PLIF group. The amount of bleeding in group MIS-TLIF was less than that in PLIF group. The operation time of MIS-TLIF group was greater than that of PLIF group. MIS-TLIF group were superior to PLIF group in 1 days， 3 days and 1 weeks after operation of CK level， VAS， ODI indexes. There was no significant difference in CK level， VAS and ODI between the two groups after 2 weeks of operation. After third months， there was no significant difference in the VAS， ODI and fusion rate between the two groups. Conclusion： MIS-TLIF has the advantages of less bleeding and less injury to the muscle of the vertebral side. MIS-TLIF is a good surgical treatment of lumbar spinal stenosis.
【Keywords】
minimally invasive transforaminal lumbar interbody fusion; lumbar spinal stenosis; retrospective clinical controlled study
腰椎管狹窄症为脊柱退行性疾病，在退变基础上发生腰椎间盘突出、关节突增生内聚、黄韧带增厚、神经根管骨性狭窄等压迫神经出现相应症状、体征。多种手术方式治疗腰椎管狭窄症均可对神经根管、椎管减压，解除神经压迫，重建脊柱稳定性，治疗效果明确。何种手术方式对患者是最佳选择，目前仍有争议。贵州省骨科医院近四年收治各型单节段腰椎管狭窄症患者行PLIF及MIS-TLIF手术145人，现比较分析两种术式临床疗效如下。, http://www.100md.com(陈啟鸰 王力航 陆廷盛 姚书眈 罗春山)
【关键词】通道下微创经椎间孔腰椎椎体间融合术;腰椎管狭窄症;回顾性临床对照研究
【中图分类号】R969.4 【文献标识码】B 【文章编号】1672-3783(2018)11-0206-01
【Abstract】Objective：
To compare the minimally invasive transforaminal lumbar interbody fusion(MIS-TILF)with open posterior lumbar interbody fusion(PLIF) for treatment of single segment lumbar spinal stenosis. Methods： In 145 cases of single segment lumbar spinal stenosis were retrospectively analyzed from June 2012 to June 2016 in our hospital. Operation time， intraoperative blood loss， serum creatine kinase level(CK) at the same time after operation， preoperative and postoperative visual analogue scale(VAS)， preoperative and postoperative oswestry disability index(ODI)， fusion rate as the observation indexes. Compare the clinical efficacy of MIS-TILF and PLIF with reference to the above indexes. Results： There was no significant difference in gender， age， course of disease， VAS and ODI between the MIS-TLIF group and the PLIF group. The amount of bleeding in group MIS-TLIF was less than that in PLIF group. The operation time of MIS-TLIF group was greater than that of PLIF group. MIS-TLIF group were superior to PLIF group in 1 days， 3 days and 1 weeks after operation of CK level， VAS， ODI indexes. There was no significant difference in CK level， VAS and ODI between the two groups after 2 weeks of operation. After third months， there was no significant difference in the VAS， ODI and fusion rate between the two groups. Conclusion： MIS-TLIF has the advantages of less bleeding and less injury to the muscle of the vertebral side. MIS-TLIF is a good surgical treatment of lumbar spinal stenosis.
【Keywords】
minimally invasive transforaminal lumbar interbody fusion; lumbar spinal stenosis; retrospective clinical controlled study
腰椎管狹窄症为脊柱退行性疾病，在退变基础上发生腰椎间盘突出、关节突增生内聚、黄韧带增厚、神经根管骨性狭窄等压迫神经出现相应症状、体征。多种手术方式治疗腰椎管狭窄症均可对神经根管、椎管减压，解除神经压迫，重建脊柱稳定性，治疗效果明确。何种手术方式对患者是最佳选择，目前仍有争议。贵州省骨科医院近四年收治各型单节段腰椎管狭窄症患者行PLIF及MIS-TLIF手术145人，现比较分析两种术式临床疗效如下。, http://www.100md.com(陈啟鸰 王力航 陆廷盛 姚书眈 罗春山)
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