摘要
目的对开放TLIF与微创TLIF手术进行生化指标与影像学指标的创伤定量对比分析。方法自2014-01-2015-10,共纳入61例单节段腰椎退行性疾病患者,其中27例采用开放TLIF手术,另34例行微创TLIF手术,对两组患者的围手术期指标、VAS评分和ODI指数,以及CK、IL-6、多裂肌横断面积(Mcsa)等创伤定量指标进行对比。结果两组患者的手术时间较为相近(P>0.05),但与开放TLIF组相比,微创TLIF组的术中出血量显著减少,术后下地时间也明显缩短(P<0.05);两组患者术后的VAS评分和ODI指数均有显著下降(P<0.05),组间对比,两组的改善程度无统计学差异(P>0.05)。血清IL-6和CK水平均在两组术后1 d达到高峰,并于术后3-5 d逐步下降;组间对比,开放TLIF组术后1 d的CK指标及术后1、3 d的IL-6水平,均显著高于微创TLIF组(P<0.05)。结论微创与开放TLIF手术治疗单节段腰椎退行性疾病,均可取得较好的疗效;但微创TLIF术式的出血量更少,对椎旁肌肉的损伤程度更低,术后康复更快,值得在临床推广应用。
Objective To compare the quantitative analysis of the biochemical and imaging parameters between open TLIF and minimally invasive TLIF. Methods From January 2014 to October 2015, 61 patients with lumbar degenerative disease were included in the study. 27 cases were treated with open surgery TLIF, the other 34 cases underwent minimally invasive TLIF surgery. The perioperative index, VAS score and ODI index, as well as CK, IL-6, the muhifidus cross-sectional area （Mcsa） trauma quantitative index were compared between the two groups. Results The operation time of the two groups was similar （P〉0.05）. Compared with the open TLIF group, the amount of bleeding of minimally invasive TLIF group was significantly reduced, postoperative ambulation time was significantly shortened （P〈0.05）. The VAS score and ODI index of two groups decreased significantly （P〈0.05）, there was no significant difference between the two groups in the degree of improvement （P〉0.05）. The serum IL-6 and CK levels in the two groups 1 day after operation reached the peak, and 3-5 clays after operation was gradually decreased. 1 d after operation CK level and IL-6 levels at 1 and 3 days after operation in open TLIF group were significantly higher than those of minimally invasive TLIF group （P〈0.05）. Conclusion Minimally invasive TLIF and open TLIF in the treatment of lumbar degenerative disease can obtain better curative effect. Minimally invasive TLIF surgery has less bleeding and lower damage degree of paraspinal muscle, faster postoperative recovery, it is worthy of clinical application.
出处
《颈腰痛杂志》
2017年第6期559-563,共5页
The Journal of Cervicodynia and Lumbodynia
关键词
腰椎退行性疾病
微创经椎间孔腰椎椎间融合手术
创伤定量对比
lumbar degenerative disease
minimally invasive transforaminal lumbar interbody fusion
quantitative comparison of trauma
