后路椎体间融合术与经椎间孔入路腰椎融合术治疗退行性腰椎滑脱症的疗效对比及对AGEs、IL-6的影响

摘要 目的：探讨后路椎体间融合术与经椎间孔入路腰椎融合术治疗退行性腰椎滑脱症的疗效对比及对晚期糖基化终末产物（AGEs）、白细胞介素6（IL-6）的影响。方法：选择2019年1月-2019年12月在我院接受治疗的100例退行性腰椎滑脱症患者，根据手术选择方式分为观察组（n=51）和对照组（n=49）。对照组给予后路椎体间融合术(PLIF)治疗，观察组给予经椎间孔入路腰椎融合术(TLIF)治疗。比较两组患者的临床优良率、血清AGEs、IL-6、手术情况、视觉模拟评分（AVS）、Oswestry功能障碍指数（ODI）评分变化情况及并发症发生情况。结果：治疗后，两组总优良率分别为90.20%，71.43%，差异显著（P<0.05）；观察组手术时间、术中出血量、术后引流量及卧床时间均显著低于对照组，差异显著（P<0.05）；治疗前，两组血清AGEs、IL-6水平无明显差异；治疗后，两组血清AGEs水平均显著降低，且观察组低于对照组，IL-6水平显著上升，观察组低于对照组（P<0.05）；治疗前，两组AVS、ODI评分水平无明显差异；治疗后，两组AVS、ODI评分水平均显著降低，且观察组低于对照组（P<0.05）；两组并发症总发生率为3.92%、18.37%，差异具有统计学意义（P<0.05）。结论：在退行性腰椎滑脱症患者中应用经椎间孔入路腰椎融合术临床效果更好，术后AGEs、IL-6水平更低，且并发症较少。

The Effect of Posterior Interbody Fusion on Degenerative Lumbar Spondylolisthesis and the Influence on Ages and IL-6

ABSTRACT Objective: To study The effect of posterior interbody fusion on degenerative lumbar spondylolisthesis and the influence on Advanced glycation end products (ages), interleukin-6 (IL-6). Methods: 100 patients with degenerative lumbar spondylolisthesis who were treated in our hospital from January 2019 to December 2019 were selected and divided into an observation group (n=51) and a control group (n=49) according to the surgical selection method. The control group was treated with posterior interbody fusion(PLIF), and the observation group was treated with lumbar fusion via interbody foramen(TLIF). The clinical good and good rates, serum AGEs, il-6, surgical conditions, visual analogue scale (AVS), Oswestry dysfunction index (ODI) scores and complications of the two groups were compared. Results: After treatment, the total excellent and good rates of the two groups were 90.20% and 71.43% respectively, with significant difference (P < 0.05); the operation time, intraoperative bleeding volume, postoperative drainage volume and bed time of the observation group were significantly lower than those of the control group, with significant difference (P < 0.05); before treatment, there was no significant difference in serum ages and IL-6 levels between the two groups; after treatment, the serum ages levels of the two groups were significantly reduced, and the observation group was lower than the control group The level of IL-6 in the observation group was significantly higher than that in the control group (P < 0.05); before treatment, there was no significant difference in the scores of AVS and ODI between the two groups; after treatment, the scores of AVS and ODI in the two groups were significantly lower than that in the control group (P<0.05); the total incidence of complications in the two groups was 3.92% and 18.37%, the difference was statistically significant (P<0.05). Conclusion: In patients with degenerative lumbar spondylolisthesis, the clinical effect of lumbar fusion via intervertebral foramen is better, the levels of ages and IL-6 are lower, and the complications are less.