MIS-TLIF内固定治疗在腰椎退变性疾病患者中的应用及效果

目的探讨微创经椎间孔腰椎椎间融合术(MIS-TLIF)内固定治疗腰椎退变性疾病的临床疗效和安全性。方法运用随机数字表法将2010年9月至2012年9月深圳市第二人民医院骨科收治的56例腰椎退变性疾病患者分为A组和B组,各28例,A组患者进行传统开放经椎间孔椎体间融合术(TLIF)治疗,B组采用MIS-TLIF进行治疗,比较两组患者手术时间、术中失血量、手术部位切口长度以及患者术后住院时间、住院费用、引流量、并发症发生率、椎间隙高度、椎间融合率、疼痛视觉模拟量表评分、日本骨科学会评分和Oswestry功能障碍指数等临床指标。结果 B组患者手术时间、术中出血量显著少于A组,手术部位切口长度显著小于B组(P<0.05);B组患者术后住院时间、住院费用、引流量显著显著少于A组,术后并发症发生率显著低于A组(P<0.05);两组患者治疗前和治疗后6个月椎间隙高度、疼痛视觉模拟量表评分、日本骨科学会评分和Oswestry功能障碍指数比较差异均无统计学意义(P>0.05)。结论 MIS-TLIF内固定治疗腰椎退变性疾病患者临床疗效肯定,优于传统开放TLIF手术治疗,有明显的优势,值得进一步推广。

Application Effect of Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Disease

Objective To investigate the clinical efficacy and safety of minimally invasive transforaminal lumbar interbody fusion（MIS-TLIF） on the lumbar degenerative disease.Methods The clinical data of 96 patients with the lumbar degenerative disease treated in the department of orthopedics in Shenzhen Second People＇s Hospital from Sep.2010 to Sep.2012 were included,they were divided into group A（n =48）and group B（n=48） with random number table method,group A was given the traditional open transforaminal lumbar interbody fusion（TLIF）,while the group B was given the MIS-TLIF,the operation time,intraoperatve blood soss,incision length,postoperative hospitalization length,hospitalization cost,drainge volume,complications incidence,intervertebral space height,intervertebral fusion rate,scores of visual analogue scale,the scores of Japanese orthopedic association and Osweshy disability index of the two groups were compared.Results The operation time,intraoperatve blood loss,incision length,postoperative hospitalization length,hospitalization cost,drainge volume,complication incidence of group B were significantly less than group A （P 〈 0.05）,but the intervertebral space height,intervertebral fusion rate,scores of visual analogue scale,scores of Japanese orthopaedic association and Osweshy disability index of two group were not statistically significantly different before treatment and 6 months after treatment（P 〉 0.05）.Conclusion MIS-TLIF is superior than the traditional open TLIF with obvious advantages,which is worth of further promotion.