经多裂肌间隙入路TLIF与传统PLIF治疗30例腰椎间盘突出症疗效比较

目的:比较经多裂肌间隙入路椎间孔椎体间融合术(TLIF)和传统腰椎后路腰椎间融合术(PLIF)在腰椎间盘突出症的临床疗效。方法:选择腰椎间盘突出症的患者60例,根据手术方式不同随机分为两组(PLIF组和TLIF组),每组各30例。比较两组患者手术时间、术中出血量、术后引流量、术后住院天数、椎体间融合率、椎体融合时间以及术后并发症;手术前后VAS评分和ODI功能障碍指数评分。结果:①TLIF组的手术时间、术中出血量、术后引流量均比PLIF组明显降低(P0.05);两组术后住院时间、椎体间融合率和椎体融合时间比较无显著差异(P0.05)。②TLIF组术后VAS评分和ODI评分均比PLIF组明显降低;③TLIF组的术后神经损伤、固定物松动移位和硬脊膜撕裂脑脊液漏发生率均比PLIF组明显降低(P0.05)。结论:采用经多裂肌间隙入路TLIF技术治疗腰椎间盘突出症较传统PLIF技术疗效好、创伤小、出血少、术后并发症少,值得临床推广应用。

Comparison of therapeutic effect of Transforaminal lumbar interbody fusion through Intra -multifidns muscle space and traditional Posterior lumbar interbody fusion on Lumbar disc herniation

Objective To compare the therapeutic effect of Transforaminal lumbar interbody fusion （TLIF）through Intra -mul-tifidns muscle space and traditional Posterior lumbar interbody fusion （PLIF）on Lumbar disc herniation.Methods Sixty patients with Lumbar disc herniation were selected and divided into two groups with 30 cases in each groups.TLIF group was given the treatment of Transforaminal lumbar interbody fusion （TLIF）through Intra -multifidns muscle space whiIe PLIF group was given the treatment of traditional Posterior lumbar interbody fusion.Operation time,bleeding volume,postoperative drainage volume and hospital stay,length of interbody fusion,rate of interbody fusion were all recorded.And preoperative and postoperative VAS and ODI score of two groups were observed and compared.Results ①The operation time,intraoperative bleeding volume and postoperative drainage volume in TLIF group were less than those in PLIF group （P〈0.05）;There were no significant difference of length of interbody fusion,rate of inter-body fusion and postoperative hospital stay between the two groups （P 〉0.05）;② Postoperative VAS and ODI score in group TLIF were significantly lower when compared with PLIF group （P 〈0.05）;③ There were lower incidence of posetoperative complication in-cluding nerve injury,fixation loosening,dural tear and leakage of cerebrospinal fluid in group TLIF than those in group PLIF （P ＆lt;0.05）.Conclusion The therapeutic effect of TLIF through Intra -multifidns muscle space on Lumbar disc herniation is obvious,less trauma,less bleeding and less complication,which is worthy of clinical application.