中国医学创新2024，Vol.21Issue(16)：32-37,6.DOI:10.3969/j.issn.1674-4985.2024.16.007
MIS-TLIF下单边固定与双边固定治疗单节段单侧腰椎间盘突出症的效果比较
Comparative Study of Unilateral and Bilateral Fixation in the Treatment of Single-Segment Unilateral Lumbar Disc Herniation under MIS-TLIF
摘要
Abstract
Objective:To compare the safety and efficacy of unilateral and bilateral fixation in the treatment of single-segment unilateral lumbar disc herniation under minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF).Method:A retrospective analysis of clinical data from patients with lumbar disc herniation treated with MIS-TLIF fixation at the Department of Spinal Surgery,Chengdu Sport University Affiliated Hospital from 2020 to 2022.This study included 58 patients,28 cases in the unilateral fixation group and 30 cases in the bilateral fixation group.Preoperative,postoperative 1 month,6 months and 1-year,Oswestry disability index(ODI),visual analog scale(VAS)scores,and fusion rate were collected to evaluate the clinical efficacy of different fixation methods.The coronal surface angle(CSA),L4 tilt angle(L4TA),disc wedging angle(DWA),and coronal balance distance(CBD)were collected before and 1 year after operation to analyze the effects of two different fixation methods on spinal coronal balance.The lumbar lordosis angle of the two groups before and 1 year after operation was analyzed to evaluate the effects of the two fixation methods on the sagittal plane of the lumbar spine.Result:The operation time and intraoperative blood loss in unilateral fixation group were significantly less than those in bilateral fixation group(P<0.05).Coronal parameters:CSA,CBD,and L4TA were improved in bilateral fixation group(P<0.05),and L4TA was improved in unilateral fixation group(P<0.05).The bilateral fixation group was better than the unilateral fixation group in improving CBD(P<0.05).For sagittal plane parameters,bilateral fixation group can significantly improve lumbar lordosis angle(P<0.05).One year after operation,the VAS score of unilateral fixation group decreased from(6.77±0.73)points before operation to(0.92±0.26)points,and that of bilateral fixation group decreased from(6.73±0.59)points before operation to(1.67±0.72)points.The unilateral fixation group was better than bilateral fixation group(P<0.05).One year after operation,the ODI of unilateral fixation group decreased from(36.00±5.91)to(4.77±2.36),and that of bilateral fixation group decreased from(39.06±10.09)to(14.40±8.11).The ODI of unilateral fixation group was better than that of bilateral fixation group(P<0.05).There were no non-fusion cases in both groups.Conclusion:Unilateral fixation in MIS-TLIF has a definite effect in treating single-segment unilateral lumbar disc herniation.At the same time,it has advantages in terms of intraoperative blood loss,operation time.However,the bilateral fixation group demonstrated superior improvement in coronal and sagittal plane balance of the spine.关键词
腰椎间盘突出症/微创通道下经椎间孔腰椎椎间融合术/单边固定Key words
Lumbar disc herniation/Minimally invasive transforaminal lumbar interbody fusion/Unilateral fixation引用本文复制引用
丁华,但晶..MIS-TLIF下单边固定与双边固定治疗单节段单侧腰椎间盘突出症的效果比较[J].中国医学创新,2024,21(16):32-37,6.基金项目
成都体育学院附属体育医院/运动医学国家体育总局/四川省重点实验室2020年临床创新课题项目(LCCX20C04) （LCCX20C04）
