微创经椎间孔入路椎间植骨融合术治疗腰椎滑脱的临床疗效

目的 探讨微创经椎间孔入路椎间植骨融合术治疗腰椎滑脱的临床疗效。 方法 选择新疆医科大学第六附属医院于2012年3月—2015年3月期间收治的腰椎滑脱症患者98例,依据随机数字表法随机分为观察组49例与对照组49例。观察组中,男性患者31例,女性患者18例;其中腰椎峡部裂性滑脱29例,腰椎退行性滑脱20例;按照Meyerding分度标准:Ⅰ度滑脱23例,Ⅱ度滑脱26例。对照组49例中,男性患者30例,女性患者19例;其中腰椎峡部裂性滑脱30例,腰椎退行性滑脱19例;按照Meyerding分度标准:Ⅰ度滑脱22例,Ⅱ度滑脱27例。对照组采用开放经椎间孔椎间融合术治疗,观察组采用微创经椎间孔入路椎间植骨融合术治疗。 结果 观察组术中出血量、术后下床活动时间及术后引流量均优于对照组(P<0.05);观察组优良率(89.80%)高于对照组(63.26%),P<0.05;观察组术后1、3、6、12个月视觉模拟评分(VAS)评分低于同期对照组(P<0.05);观察组术后1、3、6、12个月腰椎评分标准(JOA)高于同期对照组(P<0.05);观察组术后1、3、6、12个月Oswestry功能障碍指数(ODI)评价高于同期对照组(P<0.05)。 结论 微创经椎间孔入路椎间植骨融合术治疗腰椎滑脱的临床疗效显著,具有重要研究意义。 

Clinical effect of minimally invasive posterior lumbar interbody fusion in the treatment of lumbar spondylolisthesis

Objective To investigate the clinical effect of minimally invasive posterior lumbar interbody fusion (PLIF) in the treatment of lumbar spondylolisthesis. Methods Total 98 cases of lumbar spondylolisthesis were selected from our hospital from March, 2012 to March, 2015. According to the random number table method, he patients were randomly divided into observation group and control group of 49. In the observation group, there were 31 cases of male patients and 18 female patients, including 29 cases of lumbar isthmic spondylolisthesis and 20 cases of lumbar degenerative spondylolisthesis; according to the standard of Meyerding classification:Ⅰ spondylolisthesis in 23 cases, Ⅱ 26 cases of spondylolisthesis. In the control group, there were 30 cases of male patients and 19 female patients, including 30 cases of lumbar isthmic spondylolisthesis and 19 cases of lumbar degenerative spondylolisthesis; according to the standard of Meyerding classification:Ⅰ spondylolisthesis in 22 cases, Ⅱ 27 cases of spondylolisthesis. The control group received open lumbar interbody fusion therapy, while the observation group received minimally invasive posterior lumbar interbody fusion. Results The intraoperative blood loss, time to ambulation after the surgery and postoperative drainage volume in the observation group were better than those of the control group (P < 0. 05); The excellent and good rate (89. 80%) in the observation group was higher than that of the control group (63. 26%), P < 0. 05. VAS score in 1 month, 3 months, 6 months and 12 months after the treatment in the observation group was lower than those in the control group (P < 0. 05), and was reverse for JOA score and ODI score (P < 0. 05). Conclusion The minimally invasive PLIF in the treatment of lumbar spondylolisthesis has significant clinical effect, and it is of great significance.