摘要
目的探讨腰椎退行性疾病患者采用正中入路微创经后方椎间孔入路腰椎融合术(MIS-PTLIF)治疗对其腰椎功能恢复及并发症的影响。方法选择2021年12月—2023年6月期间秦皇岛市第一医院收治的84例腰椎退行性疾病患者,按照随机数字表法将其分为两组:对照组42例采用传统开放式腰椎后路融合术(PLIF),观察组42例采用正中人路MIS-PTLIF。比较两组围术期相关指标,不同时间点视觉模拟量表(VAS)评分、肌酸磷酸激酶(CPK)水平、Oswestry功能障碍指数(ODI)评分以及术后并发症发生情况。结果观察组在手术时间、切口长度、术中出血量、下地活动时间及住院时间方面均优于对照组(均P<0.05)。两组术前VAS和ODI评分比较差异无统计学意义(均P>0.05)。术后1周、术后3个月,两组VAS评分、ODI评分均显著低于术前(均P<0.05)。观察组术后1周的VAS评分、ODI评分均显著低于对照组(均P<0.05)。两组术前1d血清CPK水平差异无统计学意义(P>0.05)。观察组术后第1、3、5天血清CPK水平明显低于对照组(均P<0.05),观察组术后第5天血清CPK水平与术前1d相当(P>0.05),对照组术后第5天血清CPK水平仍高于术前1d(P<0.05)。两组患者术后并发症发生率及融合率比较差异无统计学意义(均P>0.05)。结论MIS-PTLIF治疗腰椎退行性疾病短期疗效较好,能够有效缓解患者术后疼痛,并有助于其腰椎功能恢复,且安全性及融合率与传统PLIF相当,值得临床推广。
Objective To explore the effect of midline approach minimally invasive posterior transforaminal lumbar interbody fusion(MIS-PTLIF)on lumbar function recovery and complications in patients with lumbar degenerative diseases.Methods A total of 84 patients with lumbar degenerative diseases admitted to the First Hospital of Qinhuangdao from December 2021 to June 2023 were selected and divided into two groups according to the random number table method:42 cases in the control group were treated with traditional open posterior lumbar interbody fusion(PLIF),and 42 cases in the observation group were treated with midline approach MIS-PTLIF.Perioperative related indicators,Visual Analogue Scale(VAS)scores,creatine phosphokinase(CPK)levels,Oswestry Disability Index(ODI)scores at different time points,and the incidence of postoperative complications were compared between the two groups.Results The observation group was superior to the control group in operation time,incision length,intraoperative blood loss,time to get out of bed,and hospital stay(all P<0.05).There were no significant differences in preoperative VAS and ODI scores between the two groups(all P>0.05).At 1 week and 3 months after surgery,the VAS and ODI scores of both groups were significantly lower than those before surgery(all P<0.05).The VAS and ODI scores of the observation group at 1 week afer surgery were significantly lower than those of the control group(all P<0.05).There was no significant difference in serum CPK level between the two groups 1 day before surgery(P>0.05).The serum CPK levels of the observation group on the Ist,3rd,and 5th days after surgery were significantly lower than those of the control group(all P<0.05).The serum CPK level of the observation group on the 5th day after surgery was comparable to that 1 day before surgery(P>0.05),while that of the control group on the 5th day after surgery was still higher than that 1 day before surgery(P<0.05).There were no significant differences in the incidence of postoperative complications and fusion rate between the two groups(all P>0.05).Conclusions MIS-PTLIF has a good short-term effect in the treatment of lumbar degenerative diseases,which can effectively relieve postoperative pain,help the recovery of lumbar function,and its safety and fusion rate are comparable to traditional PLIF,which is worthy of clinical promotion.
作者
孙凤丽
刘志新
刘然
齐颖钊
Sun Fengli;Liu Zhixin;Liu Ran;Qi Yingzhao(Department of Orthopaedics,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China)
出处
《中国医师杂志》
2025年第8期1202-1207,共6页
Journal of Chinese Physician
基金
秦皇岛市科学技术研究与发展计划项目(202101A152)。
关键词
腰椎退行性变
腰椎椎间融合术
微创外科手术
腰椎功能
Lumbar degenerative disease
Lumbar interbody fusion
Minimally invasive surgery
Lumbar spine function
