微创经椎间孔椎体间融合术与开放手术治疗腰椎滑脱症临床疗效观察

目的探讨微创经椎间孔椎体间融合术与开放手术治疗腰椎滑脱症的临床疗效。方法选取本院2008年1月至2011年6月收治的腰椎滑脱症患者86例,随机分为两组,采用传统开放手术治疗的患者43例为对照组,采用微创经椎间孔椎体间融合术治疗的患者43例为观察组。从术中出血量、术后引流量、手术时间、住院时间、术中术后异体血回输量、腰痛视觉模拟疼痛评分、日本矫形外科协会下腰痛评分、术后并发症、术后疗效等方面进行比较。结果观察组术中出血量、术后引流量、术中术后异体血回输量、住院时间均明显少于对照组,而观察组手术时间明显多于对照组,差异均有统计学意义(P<0.05)。治疗后观察组和对照组腰痛视觉模拟疼痛评分均明显下降,治疗后观察组和对照组日本矫形外科协会下腰痛评分均明显上升,治疗后观察组腰痛视觉模拟疼痛评分明显低于对照组,而治疗后观察组日本矫形外科协会下腰痛评分明显高于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率低于对照组,观察组总有效率和融合率均高于对照组,差异均无统计学意义(P>0.05)。结论采用微创经椎间孔椎体间融合术治疗腰椎滑脱症是安全有效的,具有手术操作简便、创伤反应小、术中出血量少、术后并发症少、术后疼痛轻、恢复快、住院时间短等优点,值得临床推广使用。

Comparative study on the clinical effect of minimally invasive transforaminal lumbar interbody fusion and open operation in the treatment of lumbar spondylolisthesis.

Objective To investigate the clinical efficacy of minimally invasive transforaminal lumbar interbody fusion and open operation in the treatment of lumbar spondylolisthesis. Methods Eighty-six patients with lumbar spondylolisthesis in our hospital from January 2008 to June 2011 were selected and divided into two groups randomly. The control group (n=43) received traditional open operation, while the study group (n=43) was treated by minimally invasive transforaminal lumbar interbody fusion. The intraoperative blood loss, postoperative drainage volume, operation time, hospital stay, intraoperative and postoperative allogeneic blood transfusion volume, pain visual analog pain score, the Japanese Orthopaedic Association of low back pain score, postoperative complications, postoperative curative effect were compared. Results The intraoperative blood loss, postoperative drainage volume, intraoperative and postoperative allogeneic blood transfusion volume, duration of hospital stay in the study group were significantly less than those in the control group. The operation time in the study group was significantly more than that in the control group (P<0.05). The low back pain visual analog pain score in the two groups decreased significantly after the treatment. Japanese Orthopaedic Association low back pain score in the two groups increased significantly after the treatment. The low back pain visual analog pain score in the study group was significantly lower than that in the control group after the treatment. Japanese Orthopaedic Association low back pain score in the study group was significantly higher than that in the control group after the treatment (P<0.05). The complication rate in the study group was lower than that in the control group. The total effective rate and convergence rate in the study group were higher than those in the control group, with no statistically significant differences (P>0.05). Conclusion Minimally invasive transforaminal lumbar interbody fusion is a safe and effective method for the treatment of lumbar spondylolisthesis, having the advantages of simple operation, small operation wound responses, less bleeding, less postoperative complications, postoperative pain, rapid recovery, shorter hospital stay, which is worthy to be extended in clinical practice.