MIS-TLIF与TLIF治疗单节段腰椎退行性疾病近期疗效的对比分析

摘要 目的：对比分析微创经椎间孔入路腰椎椎间融合术（MIS-TLIF）与传统经椎间孔腰椎椎体间融合术（TLIF）治疗单节段腰椎退行性疾病近期疗效。方法：回顾性选取我院2018年4月-2020年12月收治的72例单节段腰椎退行性疾病患者的临床资料，根据手术方式分为A组（n=36，给予TLIF治疗），B组（n=36，给予MIS-TLIF治疗）。对比两组患者手术指标（手术时间、术中出血量、切口长度）；对比两组患者手术前和手术后1个月、手术后6个月疼痛程度和腰椎功能；对比两组患者椎间融合率。结果：相比于A组，B组手术时间更长，切口长度更短，术中出血量更少（P＜0.05）；相比于A组，B组手术后1个月、手术后6个月视觉模拟评分法（VAS）评分均更低（P＜0.05）；相比于A组，B组手术后1个月、手术后6个月日本骨科协会（JOA）评分均更高（P＜0.05）。B组椎间融合率为97.22%（35/36）与A组的88.89%（32/36）比较差异无统计学意义（P＞0.05）。结论：与TLIF治疗相比，采用MIS-TLIF治疗单节段腰椎退行性疾病患者，手术时间更长，但对于患者疼痛的缓解和腰椎功能的改善更为明显。

Comparative Analysis of the Short-Term Curative Effect of MIS-TLIF and TLIF in the Treatment of Single Segment Lumbar Degenerative Diseases

ABSTRACT Objective: To compare the short-term efficacy of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of single segment lumbar degenerative diseases. Methods: Clinical data of 72 patients with single segment lumbar degenerative disease admitted to our hospital from April 2018 to December 2020 were retrospectively selected. According to surgical methods, they were divided into group A (n=36, TLIF treatment) and group B (n=36, MIS-TLIF treatment). The operation indexes (operation time, intraoperative blood loss, incision length) of the two groups were compared. The degree of pain and lumbar function in the two groups before operation, 1 month after operation and 6 month after operation were compared. The intervertebral fusion rate of the two groups was compared. Results: Compared with group A, group B had longer operation time, shorter incision length, and less intraoperative blood loss (P<0.05). Compared with group A, visual analogue scale (VAS) scores in the group B at 1 month after operation and 6 months after operation were lower (P<0.05). Compared with group A, the Japanese Orthopaedic Association (JOA) scores in the group B at 1 month after operation and 6 months after operation were higher (P<0.05). The interbody fusion rate in group B was 97.22% (35/36) higher than 88.89% (32/36) in group A, and the difference was not statistically significant (P>0.05). Conclusion: Compared with TLIF treatment, mis-tlif treatment of patients with single segment lumbar degenerative diseases has a longer operation time, but it is more obvious for the relief of pain and the improvement of lumbar function.