TLIF与PLIF治疗复发性腰椎间盘突出症的对比研究

目的探讨和对比经腰椎间孔人路腰椎椎间植骨融合术（TLIF）与后路腰椎椎体间植骨融合术（PLIF）治疗腰椎间盘突出症的临床效果。方法选取黑龙江省大庆市龙南医院骨科80例腰椎间盘突出症复发的患者，将其分为TLIF组和PLIF组，每组各40例。TLIF组给予TLIF术治疗，PLIF组给予PLIF术治疗。观察和比较两组手术时间、术中出血量、卧床时间、椎体间融合率、融合时间、VAS和ODI评分、临床疗效及并发症等情况。结果TLIF组手术时间与术巾出血量均少于PLIF组，差异有统计学意义（P〈0．05）。两组治疗后VAS、ODI评分与治疗前比较，差异有统计学意义（P〈0．05）；治疗后TLIF组VAS、ODI评分与改善率与PLIF组比较，差异均有统计学意义（均P〈0．05）。TLIF组总有效率为90．0％，PLIF组总有效率为87．5％，差异有统计学意义（P〈0．05）。结论TLIF治疗复发性腰椎间盘突出症与PLIF相比更有效、更安全，值得临床推广应用。

Comparative study on transforam inal lumbar interbody fusion and posterior lumbar interbody fusion in the treatment of recurrent lumbar disc herniation

Objective To discuss and compared the clinical effect on transforam inal lumbar interbody fusion and pos- terior lumbar interbody fusion in the treatment of recurrent lumbar disc herniation. Methods 80 patients with recurrent lumbar disc herniation in Department of Orthopedics, Longnan Hospital of Daqing City were selected and divided into TLIF group and PLIF group, each group had 40 cases. TLIF group was given the treatment of transforam inal lumbar interbody fusion while PLIF group was given the treatment of posterior lumbar interbody fusion. Operation time, bleed during operation, duration of hospital stays, length of interbody fusion, rate of interbody fusion, VAS and ODI score, clinical effect of two groups were observed and compared. Results Operation time, bleed during operation of TLIF group were less than those of PLIF group （P 〈 0.05）; after treatment, VAS and ODI score of two groups were less than those of before treatment, there was significant difference （P 〈 0.05）; after treatment, there were significant differences in VAS and ODI score and improvement rate of TLIF group which compared with PLIF group （P 〈 0.05）. The total ef- fective rate of TLIF group was 90.0% while PLIF group was 87.5%, there was significant difference （P 〈 0.05）. Conclusion TLIF in the treatment of recurrent lumbar disc herniation has more effect and more safty which compared with PLIF, so it is worthy to use in clinic.