单节段腰椎退变性疾病患者不同手术方式临床效果观察

发布时间：2018-12-16 08:09

【摘要】：目的比较改良的后路腰椎体间融合术(PLIF)与后路经椎间孔入路椎体间融合术(P-TLIF)治疗单节段腰椎退变性疾病的临床综合疗效。方法将150例单节段腰椎退变性患者分成两组,分别使用改良的PLIF手术与P-TLIF手术治疗,记录所有患者手术时间、术中出血量、椎间隙植骨量、术后住院时间、椎间融合率、术前和术后VAS评分及JOA评分。结果两组患者术后住院时间、椎间融合率差异无统计学意义(P0.05);P-TLIF组术中出血量及手术时间均少于改良的PLIF组,P-TLIF组椎间隙植骨量多于改良的PLIF组(P均0.05);改良的PLIF组术后1个月和术后3个月的VAS评分低于术前(P0.05)。改良的PLIF组术后1个月和术后3个月的JOA评分高于术前(P0.05),术后第1天VAS评分P-TLIF组低于改良的PLIF组(P0.05),JOA评分差异无统计学意义(P0.05);术后1、3个月随访两组间VAS评分及JOA评分差异均无统计学意义(P0.05)。结论 P-TLIF治疗单节段腰椎退变性可以获得与改良PLIF手术相同的临床效果,且具有手术时间短、术中出血少、神经损伤轻等临床优势。
[Abstract]:Objective to compare the clinical effects of modified posterior lumbar interbody fusion (PLIF) and posterior interbody fusion (P-TLIF) through interforaminal approach in the treatment of single segment lumbar degenerative diseases. Methods one hundred and fifty patients with single segmental lumbar degenerative degeneration were divided into two groups. All patients were treated with modified PLIF operation and P-TLIF operation respectively. The time of operation, the amount of blood lost during operation, the amount of bone graft in intervertebral space, the time of hospitalization after operation and the rate of intervertebral fusion were recorded. VAS score and JOA score before and after operation. Results there was no significant difference in postoperative hospitalization time and intervertebral fusion rate between the two groups (P0.05). The amount of intraoperative bleeding and operative time in P-TLIF group was less than that in modified PLIF group, and the bone graft volume in intervertebral space in P-TLIF group was more than that in modified PLIF group (P 0.05). The VAS score of the modified PLIF group was lower than that of the preoperative group at 1 month and 3 months postoperatively (P0.05). The JOA score of the modified PLIF group was higher than that of the preoperative group at 1 month and 3 months after operation (P0.05), and the VAS score in the P-TLIF group was lower than that in the modified PLIF group on the first day (P0.05). There was no significant difference in the), JOA score between the two groups (P0.05). There was no significant difference in VAS score and JOA score between the two groups 1 and 3 months after operation (P0.05). Conclusion P-TLIF can obtain the same clinical effect as the modified PLIF operation in the treatment of single segmental degenerative lumbar vertebrae, and it has the advantages of short operative time, less intraoperative bleeding and less nerve injury.
【作者单位】：宁夏医科大学总医院脊柱外科;
【分类号】：R687.3

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