TLIF与PLIF治疗老年退变性腰椎滑脱并椎管狭窄症的比较

发布时间：2018-04-28 08:39

本文选题：腰椎滑脱 + 腰椎管狭窄症　；参考：《中国矫形外科杂志》2017年17期

【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(P0.05)。患者术后平均随访1年,两组术后滑脱度均明显降低(P0.05),且TLIF组低于PLIF组(P0.05)。术后两组VAS评分、ODI评分均显著降低(P0.05),但两组间无明显差异(P0.05)。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(P0.05)。TLIF组并发症发生率为4.35%,显著低于PLIF组的19.57%(P0.05)。[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。
[Abstract]:[objective] to investigate the clinical effect of transforaminal interbody fusion (TLIFs) and posterior lumbar interbody fusion (PLIFF) in senile degenerative lumbar spondylolisthesis with lumbar spinal stenosis. [methods] 92 cases of senile degenerative lumbar spondylolisthesis with lumbar spinal stenosis were randomly divided into two groups: TLIF group and PLIF group. The indexes of perioperative period, the correction of spondylolisthesis and VAS score, the index of Oswestry dysfunction, the rate of intervertebral bone graft fusion, and the postoperative complications were compared between the two groups. [results] the time of operation, the amount of blood lost during operation and the amount of blood produced after operation in TLIF group were significantly lower than those in PLIF group (P 0.05). The patients were followed up for an average of 1 year. The degree of slippage in both groups was significantly lower than that in the PLIF group (P 0.05), and that in the TLIF group was lower than that in the PLIF group (P 0.05). The VAS scores and ODI scores of the two groups decreased significantly after operation, but there was no significant difference between the two groups. The successful rate of postoperative fusion was 87.00% in the TLIF group and 91.30% in the PLIF group. The incidence of complications in the TLIF group was 4.35%, which was significantly lower than that in the PLIF group (19.57% P0.05%). [conclusion] TLIF-PLIF is effective in the treatment of senile degenerative lumbar spondylolisthesis with lumbar spinal stenosis.
【作者单位】：北京积水潭医院脊柱外科;北京市创伤骨科研究所;
【分类号】：R687.3

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