两种方式治疗单节段腰椎间盘突出症的疗效比较OACSTPCD

Objective To compare the clinical efficacy of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)with unilateral pedicle fixation and transforaminal lumbar interbody fusion(TLIF)with unilateral pedicle fixation for treatment of single-level lumbar disc herniation(LDH).Methods The 55 patients with single-level LDH were divided into MIS-TLIF(MIS-TLIF group,29 cases)and TLIF(TLIF group,26 cases).The operation time,inci-sion length,intraoperative blood loss,postoperative 24 h drainage volume,hospital stay and complications were recor-ded in two groups.Japanese Orthopaedic Association(JOA)Scores and Oswestry disability index(ODI)were used to evaluate clinical efficacy.Results All patients were followed up for 6～15 months.There were no statistical differ-ences in operation time,intraoperative blood loss and hospital stay between the two groups(P>0.05).However,the incision length and postoperative 24 h drainage volume in the TLIF group were longer(more)than those in the MIS-TLIF group(P<0.05).There were no complications such as incision infection,intervertebral space infection,internal fixation loosening,cage displacement,nerve root injury,and dural tear in both groups.At 6 months postoperation,the ODI scores and JOA scores in the two groups were improved,compared with those of before operation(P<0.05),and there were no statistical differences between the two groups(P>0.05).JOA score improvement rate had no statistical difference between the two groups at 6 months after surgery(P>0.05).Conclusions Both MIS-TLIF and TLIF with unilateral pedicle fixation can achieve satisfactory clinical efficacy in the treatment of single-level LDH,but MIS-TLIF has the advantages of smaller incision and less postoperative drainage volume.