摘要
[目的]探讨老年退变性腰椎滑脱并腰椎管狭窄症经椎间孔椎体间融合术(TLIF)与后路椎体间融合术(PLIF)的临床疗效。[方法]92例老年退变性腰椎滑脱并腰椎管狭窄症患者采用随机数字法分为2组。TLIF组给予TLIF术,PLIF组给予PLIF术。比较两组围术期指标、滑脱椎体矫正情况、VAS评分、Oswestry功能不良指数、椎间植骨融合率、术后并发症情况。[结果]TLIF组手术时间、术中出血量、术后引血量、术后卧床时间显著低于PLIF组(P<0.05)。患者术后平均随访1年,两组术后滑脱度均明显降低(P<0.05),且TLIF组低于PLIF组(P<0.05)。术后两组VAS评分、ODI评分均显著降低(P<0.05),但两组间无明显差异(P>0.05)。术后半年,TLIF组术后融合成功率为87.00%,PLIF组为91.30%,差异不显著(P>0.05)。TLIF组并发症发生率为4.35%,显著低于PLIF组的19.57%(P<0.05)。[结论]TLIF、PLIF均可有效治疗老年退变性腰椎滑脱并腰椎管狭窄症,TLIF具有创伤小、并发症少的优点。
[Objective] To compare the clinical outcomes of transforaminal lumbar interbody fusion （TLIF） versus pos- terior lumbar interbody fusion （PLIF） for treatment of degenerative lumbar spondylolisthesis combined with spinal stenosis in the elderly. [Methods] Ninety-two elderly patients with degenerative lumbar spondylolisthesis combined with spinal stenosis were randomly divided into the TLIF group and the PLIF group with 46 patients in each group. Correspondingly, the patients were surgically treated with TLIF or PLIF. The perioperative parameters, extent of spondylolisthesis, visual analogue scale （VAS） , Oswestry dysfunction index （ODI） , intervertebra] fusion rate and postoperative complications were compared be- tween the two groups. [Results] The TLIF group was significantly inferior to the PLIF group in operation time, intraoperative blood loss, postoperative drainage volume and bed rest time （P〈0.05） . All patients were followed up for 1 year on average. The postoperative grades of the slip in both groups significantly decreased compared with those before operation （P〈0.05） . By comparison, the TLIF group was significantly less in postoperative grade of the slip than the PLIF group （P〈0.05） , although no a statistical difference noted between them before operation. Additionally, the postoperative VAS score anti ODI score in both groups significantly reduced compared with those preoperatively （P〈0.05） , however, there were no significant differences be- tween the two groups at same time points （P〉 0.05） . Furthermore, the postoperative fusion rate was 87.00% in the TLIF group, while 91.30% in the PLIF group without a significant difference between them （P〉0.05） . Moreover, the incidence of complication proved 4.35% versus 19.57%, the TLIF group was significantly lower than the PLIF group （P〈0.05） . [Conclusion] lumbar spondylolisthesis, lumbar spinal stenosis, transforaminal lumbar interbody fusion （TLIF） , posterior lumbar interbody fusion （PLIF）
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第17期1537-1540,共4页
Orthopedic Journal of China
关键词
腰椎滑脱
腰椎管狭窄症
经后路椎体间融合术
经椎间孔椎体间融合术
lumbar spondylolisthesis, lumbar spinal stenosis, posterior interbody fusion, intervertebral for interbody fusion
