摘要
Abstract
Objective To compare clinical results of minimally transforaminal lumbar interbody fusion ( TLIF) and open TLIF for single segment degenerative lumbar disease .Methods All of 97 patients with single segment degener-ative lumbar disease were divided to minimal group (minimally invasive TLIF, n=51) and open group (open TLIF, n=46).These data were compared between the both groups , including operative time, intraoperative blood loss and postoperative drainage volume , total blood transfusion , back pain ( using visual analogue scale , VAS) , hospital stay , bed time, perioperative complications, clinical function (using the Oswestry disability index, ODI), and radiograph-ic results.Results All of 97 patients were followed up .The follow-up time in minimal group and open group was 28~78 (48.7 ±21.8) months and 27~76 (48.6 ±19.7) months, respectively.The operative time:minimal group (148.8 ±24.2) min, open group (191.7 ±37.6) min (P<0.001);blood loss: minimal group (482.8 ±274.8) ml, open group (787.9 ±264.3)ml (P<0.001);needs of transfusion: minimal group (379.3 ±81.6)ml, open group (619.8 ±237.6) ml (P<0.001);bed time:minimal group (1.3 ±0.8) days, open group (3.1 ±1.6) days (P<0.001);hospital stay:minimal group (4.8 ±1.7) days, open group (11.2 ±3.1) days (P<0.001).At fi-nal follow-up, back pain VAS:minimal group (1.9 ±0.8) points, open group (2.7 ±1.2) points (P<0.001). ODI:minimal group (22.8 ±9.7)%,open group (22.5 ±11.6)%( P>0.05);the rate of screw malposition:mini-mal group 3.4%, open group 2.2% ( P>0.05 );the rate of cage shift: minimal group 3.9%, open group 2.2%(P>0.05);loss value of intervertebral height: minimal group (1.3 ±0.6) mm, open group (1.5 ±0.7) mm (P>0.05);and the rate of interbody fusion:minimal group 94.1%, open group 95.7%(P>0.05).Conclusions For the single segment degenerative lumbar disease , the use of minimally invasive TLIF or open TLIF , can obtain satisfactory clinical function and radiographic results , but the former has the advantage of less invasive , shorter length of hospital stay and bed stay ,and lighter residual back pain .关键词
腰椎退变性疾病/外科手术,微创性/开放手术/后路腰椎间融合Key words
degenerative lumbar disease/surgical procedures ,minimally invasive/open operation/posterior lumbar in-terbody fusion分类
医药卫生
