TLIF手术经多裂肌间隙入路与传统后正中入路治疗腰椎退变性疾病的临床疗效分析

目的：探讨TLIF手术经多裂肌间隙入路与传统后正中入路治疗腰椎退变性疾病的临床疗效。方法将149例患者依据TLIF术入路方式不同分成两组。观察组：75例患者，采用经多裂肌间隙入路；对照组：74例患者，实施传统后正中入路。对比两组围术期各项指征与术后VASJ、OA 评分情况。结果观察组手术时间、术中出血量、切口大小、引流量均少于对照组（均为P＜0.05）；两组术前VAS评分与JOA评分无显著性差异（ P＞0.05）；术后组间评分差异明显（ P＜0.05）。结论经多裂肌间隙入路行TLIF术医治腰椎退变性疾病，对多裂肌与神经功能损伤明显较传统入路方式小，且微创、安全，值得临床推广。

Clinical Curative Effect of TLIF Surgery by the Way of Multifidus Muscle Interval and by Traditional Postmiddle Approach Treating Lumbar Degenerative Disease

Objective To study the clinical curative effect of TLIF surgery by the way of multifidus muscle interval and by traditional postmiddle approach treating lumbar degenerative disease.Methods 149 cases on the basis of the dif-ferent way of TLIF surgery were divided into two groups.Observation group：75 cases of patients , by the way of multifi-dus muscle interval;Control group：74 cases of patients , by traditional postmiddle approach.Various perioperative indi-cations and postoperative VAS , JOA scores of the two groups were compared.Results Operation time, intraoperative blood loss , incision size and flow in observation group were less than the control group （ all P〈0.05 ）;Preoperative VAS score and JOA score in two groups were of no significant difference （ P〉0.05 ）;There was significantdifference between postoperative score of the two groups （ P〈0.05 ）.Conclusions Damage on multifidus muscle and nerve function of TLIF surgery by the way of multifidus muscle interval treating lumbar degenerative disease was significantly smaller than traditional postmiddle approach , and it is minimally invasive , safe and worthy of clinical promotion.