摘要
目的 比较通道下微创经椎间孔腰椎椎体间融合术（MIS-TLIF）与传统切开后路腰椎椎体间融合术（PLIF）对单节段腰椎间盘突出症（LDH）的近期治疗效果.方法 采用椎间融合手术治疗的单节段腰椎间盘突出症患者29例.根据手术方式分为两组：MIS-TLIF组共15例,PLIF组共14例.观察两组患者手术时间、术中出血量、术后引流量、切口长度及术后下地时间,并采用日本骨科协会（JOA）评分,比较两组近期治疗效果.结果 MIS-TLIF组JOA术前评分为（13.7±4.4）分,术后评分为（24.5±1.8）分,两者差异有统计学意义（P＜0.05）.PLIF组JOA术前评分为（15.5±5.6）分,术后评分为（25.0±1.8）分,两者差异有统计学意义（P＜0.05）.关于手术时间、术中出血量、切口长度、术后下地时间及JOA评分改善率,MIS-TLIF组分别为（140±23） min、（77±47） ml、（54.5 ±3.2） mm、（3.1±0.7）d、（70.9±9.5）％,PLIF组分别为（148±16） min、（319±302） ml、（90.1±6.2） mm、（47.7±6.9）d、（69.7±10.2）％.MIS-TLIF组均未放置引流管,PLIF组术后引流量为（424±253） ml.两组间比较手术时间、JOA评分改善率差异无统计学意义（P＞0.05）.MIS-TLIF组手术出血量、术后引流量、切口长度、术后下地时间均低于PLIF组,差异均有统计学意义（P＜0.05）.结论 与PLIF比较,MIS-TLIF对于单节段腰椎间盘突出症同样具有良好的近期治疗效果,并且在手术出血量、术后引流量、切口长度和术后下地时间方面优于PLIF.
Objective To compare the short-term outcomes of minimally invasive transforaminal lumbar interbody fusion （MIS-TLIF） and the traditional posterior interbody fusion （PLIF） treatment for single-level lumbar intervertebral disc herniation.Methods During March 2014 to October 2014,29 patients with single-level lumbar intervertebral disc herniation underwent lumbar interbody fusion.They were divided into two groups according to the operation methods.Fifteen patients in the MIS-TLIF group,and 14 patients in the PLIF group.The short-term clinical outcomes of two groups were compared according to the operative time,pereoperative blood loss,postoperative drainage volume,length of incision,postoperative ambulation time and the Japanese orthopaedic association （JOA） score.Results The operative time was （140 ±23） min,pereoperative blood loss was （77 ±47） ml,length of incision was （54.5 ± 3.2） mm,postoperative ambulation time was （3.1 ± 0.7） d,and rate of the improved JOA score was （70.9 ± 9.5） % in MIS-TLIF group.The JOA score was （13.7 ± 4.4） pre-operation and （24.5 ± 1.8） post-operation.There was statistically significant diffierence in the above indexes pre-operation and post-operation （P 〈 0.05）.The MIS-TLIF group didn＇ t stand the drainage tube.The operative time was （148 ± 16） min,pereoperative blood loss was （319 ± 302） ml,postoper-ative drainage volume was （424 ± 253） ml,length of incision was （90.1 ± 6.2） mm,postoperative ambulation time was （47.7 ± 6.9） d,and rate of the improved JOA score was （69.7 ± 10.2） % in PLIF group.The JOA score was （5.5 ± 5.6） pre-operation and （25.0 ± 1.8） post-operation.There was statistically significant diffierence in the above indexes pre-operation and post-operation （P 〈 0.05）.There was no statistically significant diffierence in the operative time and rate of the improved JOA score between two groups （P 〉 0.05）.There was statistically significant diffierence in the pereoperative blood loss,postoperative drainage volume,length of incision,and postoperative ambulation time between the two groups （P 〈 0.05）.Conclusion Both the MIS-TLIF and PLIF procedures have the similar good short-term outcomes of single-level lumbar intervertebral disc herniation,but as for the perioperative blood loss,postoperative drainage volume,length of incision,and postoperative ambulation time,MIS-TLIF procedures are superior to PLIF procedures.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2015年第3期650-652,共3页
Chinese Journal of Experimental Surgery
作者简介
通信作者：皮国富，Email：gfpi2217@163．com
