作　　者： (蒋羽清）; (牛文利）; (农鲁明）; (赵书杰）; (丁寅）; (张强）; (李海波）; (周栋）; (徐南伟）;

机构地区： 南京医科大学附属常州第二人民医院脊柱外科,江苏常州213000

出　　处： 《中国骨与关节外科》 2017年第2期100-103,共4页

摘　　要： 背景:微创经椎间孔椎体间融合术(MIS-TLIF)在治疗单节段腰椎退变性疾病中能够取得满意的临床疗效。目的目的:比较微创经椎间孔椎体间融合(MIS-TLIF)与开放性经椎间孔椎体间融合(Open-TLIF)治疗单节段腰椎退变疾病的疗效。方法:选取2012年8月至2014年8月,采用MIS-TLIF治疗的单节段腰椎退变疾病患者28例,记录手术时间、术中出血量、术中X线照射时间、术后引流量、卧床时间和住院时间,并与同期行Open-TLIF手术的28例患者进行比较。所有患者定期随访,并根据ODI评分和影像学检查评估手术疗效。结果:两组病例在性别、年龄、临床诊断、病变节段、术前ODI评分等方面差异均无统计学意义(P>0.05)。MIS组手术时间和术中X线透射时间长于Open组(P<0.05);术中出血量、术后引流量、卧床时间、住院时间均明显少于Open组(P<0.05)。术后3、6、12、18个月,两组腰痛VAS评分、腿痛VAS评分、ODI评分没有明显差异(P>0.05),MIS组术后出现1例假体移位融合不良。结论:与开放TLIF相比,MIS-TLIF治疗单节段腰椎退变疾病,具有术中出血少、创伤小、术后康复快等优势。 Background：Minimally invasive transforaminal lumbar interbody fusion （MIS-TLIF） obtain satisfactory clinical effect in the treatment of single segmental lumbar degenerative disease. Objective：To compare the effect of MIS-TLIF with open transforaminal lumbar interbody fusion （Open TLIF） on the single segmental lumbar degenerative disease. Methods：In this retrospective study, 28 patients undergoing MIS-TILF and 28 patients with open TLIF for single segmental lumbar degenerate disease between August 2012 and August 2014 were enrolled. The operation time, intraoperative blood loss, intraoperative X-ray radiation time, drainage, postoperative bedridden time, and bed hospital stay were recorded. VAS and ODI scores and radiological examination were evaluated for clinical outcomes. Results：There were no significant differences in the gender, age, clinical diagnosis, involved segment, preoperative ODI score between two groups （P〉0.05）. There were less intraoperative blood loss, drainage, postoperative bedridden time, and bed hospital stay in MIS group than in open group （P〈0.05）, but more operation time and radiation exposure time in MIS group than in open group （P〈0.05）. There were no significant differences in postoperative back pain VAS score, leg pain VAS score, or ODI score between groups （P〉0.05）. Prothesis loosening occurred in one patient of MIS group. Conclusions： Compared with open PLIF, MIS-TLIF has less bleeding, less trauma and faster recovery in the treatment of single segmental lumbar degenerate disease.

关 键 词： 微创经椎间孔椎体间融合 开放经椎间孔椎体间融合 单节段腰椎退变疾病