PLIF与TLIF手术治疗老年单节段腰椎退变性疾病的临床疗效对比

目的:探讨改良后路腰椎体间融合术(PLIF)与改良经椎间孔入路腰椎体间融合术(TLIF)手术治疗老年单节段腰椎退变性疾病的临床疗效。方法:收集2009年1月-2015年1月期间我院收治的经确诊为老年单节段腰椎退变性疾病的80例患者,按照随机数字表法分为观察组和对照组,各40例;观察组患者采用TLIF手术,对照组患者采用PLIF手术;比较两组患者手术前后腰背部疼痛程度(VAS评分)与活动功能(ODI评分),临床指标及并发症发生率。结果:观察组患者手术时间、术中出血量及术后引流量均明显短于或少于对照组患者(P0.05);两组患者手术前腰背部VAS评分与ODI评分比较差异无统计学意义(P0.05),手术后6个月,两组患者腰背部VAS评分与ODI评分均明显低于手术前(P0.05),而组间比较差异无统计学差异(P0.05);观察组术后并发症总发生率为5.00%(2/40),显著低于对照组的22.50%(9/40),差异有统计学差异(P0.05)。结论:PLIF与TLIF手术治疗老年单节段腰椎退变性疾病患者在改善腰背部疼痛程度与腰椎活动功能中的疗效相当,但TLIF手术有助于显著缩短手术时间,降低术中出血量与术后引流量,降低术后并发症发生风险,值得临床推广应用。

Comparison of Clinical Efficacy of PLIF and TLIF Operation for Elderly Patients with Single Segmental Lumbar Degenerative Disease

ABSTRACT Objective: To investigate the clinical efficacy of posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) operation for elderly patients with single segmental lumbar degenerative disease. Methods: 80 cases of elderly patients with lumbar degenerative disease were selected from January 2009-January 2015, in accordance with the random number table, were divided into group and control group, 40 cases in each group, the observation group were given TLIF operation, and control group were treated with PLIF; Compared with the two groups of patients before and after the operation of lumbar pain degree (VAS score) and activity function (ODI score), clinical index and incidence of complications. Results: The operation time, intraoperative blood loss and postoperative drainage volume in the observation group were significantly shorter than those in the control group (P<0.05) and two groups had no statistical significance in patients with frontal back VAS score and ODI score (P>0.05), 6 months after surgery, the two groups of patients with lumbar back VAS score and ODI score were significantly lower than before surgery (P<0.05), and there was no significant difference between the groups (P>0.05); The incidence of postoperative complications was 5.00%(2/40) in the observation group, which was significantly lower than that in the control group 22.50%(9/40), the difference was statistically significant (P<0.05). Conclusion: PLIF and TLIF in the treatment of elderly patients with single segment lumbar degenerative disease in improving the curative effect of lumbar back pain and activity function of lumbar vertebrae in quite, but TLIF helps to significantly shorten operation time, re- duce intraoperative blood loss and postoperative drainage, reduce the postoperative complication risk. It is worthy of clinical application.