PLIF和PLF术式联合椎弓根内固定系统治疗腰椎滑脱的临床研究

目的研究外侧植骨融合(post lateral lumbar-fusion,PLF)和后方椎间融合(post lunbar interbody fusion,PLIF)术式联合椎弓根内固定系统治疗腰间椎滑落的临床效果。方法回顾性分析2007年1月至2012年1月于我院治疗的71例腰椎滑脱患者,以数字法随机分为观察组(36例)和对照组(35例)。观察组患者行PLIF治疗,对照组行PLF治疗,比较两组治疗前后的JOA评分、手术时间以及失血量等指标。结果观察组手术时间显著高于对照组,失血量多于对照组,差异均具有统计学意义(均P<0.05);观察组患者术后2年滑脱率明显低于对照组,差异具有统计学意义(P<0.05);观察组患者术后1年融合率显著高于对照组,差异具有统计学意义(P<0.05)。结论对于治疗腰椎滑落,PLF与PLIF两种手术方式各有优势,PLF治疗方式具有手术时间短、出血量小的优点,而PLIF治疗方式内固定失败率低、融合率高,疗效更为明显。临床治疗中,可根据实际情况选择应用。

Clinical Study of PLIF and PLF Surgery Combined with Pedicle Screw Internal Fixation System as a Treatment for Lumbar Spondylolisthesis

Objective To study the clinical effect of post lateral lumbar-fusion （PLF） and post lunbar interbody fusion （PLIF） surgery modes combined with pedicle screw internal fixation system in the treatment of lumbar spondylolisthesis. Methods 71 patients with lumbar spondylolisthesis treated in our hospital from January 2007 to January 2012 were retrospectively analyzed, and according to the digital method were randomly divided into the observation group （36 cases） and control group （35 cases）. The observation group were treated with PLIF, and the control group with PLF, and JOA score, operation time and volume of blood loss between two groups before and after treatment were compared. Results The operation time of the observation group was significantly higher than that of the control group, blood loss volume was higher than that of the control group, and the differences were statistically significant （P 〈0.05）. The detachment rate at 2 years after operation of patients in the observation group, was significantly lower than that of the control group, and the difference was statistically significant （P〈0.05）. The fusion rate of patients at 1 years after operation in the observation group was significantly higher than that of the control group, and the difference was statistically significant （P〈0.05）. Conclusions For the treatment of lumbar slide, each operation mode of PLF and PLIF has advantages, of which PLF has the advantages of shorter operation time, smaller hemorrhage volume , while PLIF treatment has advantages of lower failure rate ,higher fusion rate and more obvious effect. In clinical treatment, either of them can be selected according to the actual situation.