单侧入路双侧减压TLIF手术治疗腰椎管狭窄症的疗效研究

目的 研究单侧入路双侧减压TLIF 手术与传统的PLIF 手术方式相比治疗腰椎管狭窄症的治疗效果。方法 以2016 年10 月～2017 年8 月我院收治的36 例腰椎管狭窄症患者为研究对象，将其随机分为实验组和对照组，其中对照组采用传统的PLIF 手术治疗，实验组采用单侧入路双侧减压TLIF 手术治疗，每组各18 例，比较两组患者的临床疗效及术后康复情况。结果 两组患者的手术时间、术中出血量和住院时间均差异无统计学意义（P>0.05），但实验组患者的术后引流量更少（P＜0.05）。治疗后两组患者术后第1、3 天的CPK 水平显著高于术前（P＜0.05），且实验组显著高于对照组（P＜0.05），但术后第7 天的CPK 水平两组较术前均无统计学意义（P>0.05）。术后3 个月时两组的VAS 评分和ODI 评分均较术前显著下降（P＜0.05），且实验组明显优于对照组（P＜0.05）。结论 与传统的PLIF 手术方式相比，单侧入路双侧减压TLIF 手术治疗腰椎管狭窄症的疗效更为显著，对于患者造成的手术创伤较小，术后恢复效果更好。

A study of the efficacy of bilateral decompression via unilateral approach TLIF surgery for the treatment of lumbar spinal stenosis

Objective To study the curative efficacy of bilateral decompression via unilateral approach transforaminal lumbar interbody fusion(TLIF) surgery for the treatment of lumbar spinal stenosis(LSS) in comparison with that of traditional posterior lumbar interbody fusion(PLIF) surgery.Methods From October 2016 to August 2017,36 patients with LSS admitted to and treated in our hospital were taken as the subjects of research and randomly divided into the experimental group and the control group.The control group was treated with traditional PLIF surgery,while the experimental group was treated with bilateral decompression via unilateral approach TLIF surgery,with 18 patients in each group.The clinical efficacy and postoperative rehabilitation of the two groups of patients were compared.Results There were no significant differences in operation time,intraoperative blood loss and hospitalization time between the two groups of patients(P>0.05),but the postoperative drainage volume of the patients in the experimental group was less(P<0.05).After treatment,the levels of CPK of the two groups of patients on the 1st and 3rd d after operation were significantly higher than those before operation(P<0.05),and those of the experimental group were significantly higher than those of the control group(P<0.05),but the levels of CPK of the two groups of patients on the 7th d after operation were both insignificantly different from those before operation(P>0.05).3 m after operation,the VAS scores and ODI scores of the two groups were both significantly lower than those before operation(P<0.05),and those of the experimental group were significantly superior to those of the control group(P<0.05).Conclusion Compared with that of traditional PLIF operation,the efficacy of bilateral decompression via unilateral approach TLIF surgery is more significant in the treatment of LSS.It incurs less surgical trauma to the patients and produces better effect on their postoperative recovery.