腰椎后路微创TLIF和开放PLIF两种术式临床短期效果报告

目的评价微创经椎间孔椎间融合术（transforaminal lumbar interbody fusion，TLIF）与开放后路椎间融合术（posterior lumbar interbody fusion，PLIF）行后路椎间融合及椎弓根钉内固定的短期临床疗效。方法2009年1-3月对30例腰椎退变性疾病患者分别采用微创TLIF（METRXQuadrant）和开放PLIF术式进行对照研究。结果术后1周微创TLIF组腰痛VAS评分的降低更为明显（P〈0．05）；术后1周及4个月2组腿痛VAS评分比较差异无统计学意义（P〉0．05）；术后1周微创TLIF组JOA评分同开放PLIF组比较差异具有统计学意义（P〈0．05）。结论METRX Quadrant系统下行微创TLIF后路腰椎管减压、椎间融合和椎弓根螺钉固定术，可促进患者早期康复，减少住院时间，是一种安全、可靠的方法。

Short-term effect of mini-transforaminal lumbar interbody fusion and posterior lumbar interbody fusion

Objective To evaluate the short-term effect of mini transforaminal lumbar interbody fusion （TLIF） with METRX Quadrant system and posterior lumbar interbody fusion （PLIF）. Methods From January to March 2009, 30 consecutive cases with degenerated lumbar disease and consistent with operation indication of decompression and fusion were random underwent mini-TLIF（ METRX Quadrant, group TLIF） and PLIF（ group PLIF）. VAS,JOA scales were used for evaluating the short-term curative effect at pre-operation, 1 week postoperative, 4 months postoperative respectively. Results Follow-up period ranged from 4 to 6 months with a mean of 5.1 months. VAS descent of lumbago was obtain obviously in both groups （ P 〈 0.05 ） , but more obvious in group PLIF at 1 postoperative week （ P 〈 0.05 ）. VAS descent of skelalgia was also obtain obviously in both groups （ P 〈 0.05 ）, and no difference existed between 2 groups at 1 week postoperative and 4 months postoperative （P 〉 0.05 ）. Obvious JOA descent existed in both groups, and deacent of group TLIF was different vs. group PLIF （ P 〈 0.05）. Conclusion Mini-TLIF using METRX Quadrant system can promote early rehabilitation, reduce length of stay, and is an effective and safe method for lumbar disc degencrative disease.