后外侧融合与后路椎间融合术治疗轻度腰椎滑脱的疗效对比

发布时间：2019-03-30 16:31

【摘要】：目的：比较后路椎间融合术(PLIF、posterior lumbar interbody fusion)与后外侧融合术(PLF、posterolateral fusion)治疗轻度腰椎滑脱症的临床疗效和融合率比较。方法：从2010年10月至2013年10月,在我院骨科中心,接受手术治疗的总共病例数为87名,其中符合本研究纳入标准的有50名轻度腰椎滑脱症患者。PLIF组手术方式为后路椎间融合术+椎板减压术+椎弓根螺钉内固定术+复位术；PLF组手术方式为后外侧融合术+椎板减压术+椎弓根螺钉内固定术+复位术。两组患者术中应用的植骨材料均来自于术中的椎板、棘突等自体骨。对全部患者至少进行6个月至18个月的随访。两组各有一名患者失访。应用融合率、术后并发症发生率、术后ODI优良率、住院天数、术中出血量、手术时间等指标来对两组患者进行临床疗效和影像学疗效的比较与评估。结果：平均随访时间为12个月。PLIF组患者中发生腰椎滑脱部位的分布如下：L3-4者共6名,占20%；L4-5者共15名,占50%；L5-S1者共有9名,占30%,PLF组患者中发生腰椎滑脱部位的分布如下：L3-4者共4名,占20%；L4-5者共11名,占55%；L5-S1者共有5名,占25%。PLIF组患者融合率、手术时间、并发症发生率均高于PLF组,ODI优良率、住院天数和术中出血量两组患者无明显差别。结论：PLIF组的临床疗效及影像学疗效均优于PLF组,但是PLF组的疗效也是肯定的,因此我们认为临床上个体化设计手术治疗方案时PLF也是一种重要选择。
[Abstract]:Aim: to compare the clinical efficacy and fusion rate of posterior interbody fusion (PLIF,posterior lumbar interbody fusion) and posterolateral fusion (PLF,posterolateral fusion) in the treatment of mild lumbar spondylolisthesis. Methods: from October 2010 to October 2013, the total number of cases undergoing surgical treatment was 87 in the orthopaedic center of our hospital. Among them, 50 patients with mild lumbar spondylolisthesis were included in this study. The PLIF group was treated with posterior interbody fusion, laminar decompression and pedicle screw internal fixation. PLF group was operated by posterior lateral fusion, laminar decompression, pedicle screw fixation and reduction. The bone graft materials used in both groups were derived from the vertebral lamina, spinous process and other autogenous bones. All patients were followed up for at least 6 to 18 months. One patient in each group lost a follow-up. The clinical and imaging effects of the two groups were compared and evaluated by fusion rate, incidence of postoperative complications, excellent and good rate of postoperative ODI, length of hospital stay, intraoperative bleeding and operative time. Results: the average follow-up time was 12 months. The distribution of lumbar spondylolisthesis in PLIF group was as follows: L3-4 occurred in 6 cases, accounting for 20% and L4-5 in 15 cases, accounting for 50%; The distribution of lumbar spondylolisthesis in the L5-S1 group was as follows: L3-4 in 4, 20% in L4-5, 11 in 55%; There were 5 L5-S1 patients, which accounted for the fusion rate, operation time and complication rate of 25%.PLIF group were higher than those of PLF group, ODI excellent rate, hospitalization days and intraoperative bleeding volume had no significant difference between the two groups. Conclusion: the clinical and imaging effects of PLIF group are better than that of PLF group, but the curative effect of PLF group is also positive. Therefore, we think that PLF is also an important choice in clinical individualized design of surgical treatment scheme.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
，

本文编号：2450271