摘要
Abstract
Objective To compare the clinical effect and safety of arthroscopic-assisted uni-portal spinal surgery(AUSS)with minimally invasive surgery-transforaminal lumbar interbody fusion(MIS-TLIF)in treating lumbar degenerative diseases.Methods A retrospective analysis was conducted on clinical data of 120 patients with lumbar degenerative diseases.Patients were divided into AUSS group(58 cases)or MIS-TLIF group(62 cases)according to surgical approaches.Perioperative indicators,Visual Analogue Scale(VAS)score(before surgery,1 day and 1,3,6 months after surgery,as well as the last follow-up)for lumbodorsal pain and Oswestry disability index(ODI)score(before surgery,1 day and 1,3 months after surgery,as well as the last follow-up)at different time points,imaging indices,as well as postoperative complications and adverse reactions were compared between the two groups.Results(1)Perioperative indicators:the AUSS group exhibited less intraoperative bleeding volume,and shorter out-of-bed time,a shorter total incision length,and longer operation duration compared to the MIS-TLIF group(P<0.05),but there was no statistically significant difference in length of hospital stay after surgery between the two groups(P>0.05).(2)VAS score for lumbodorsal pain and ODI score:the AUSS group interpreted a lower VAS score for lumbodorsal pain 1 day and 1 month after surgery compared to the MIS-TLIF group;furthermore,at the last follow-up,VAS score for lumbodorsal pain was lower in the MIS-TLIF group than in the AUSS group(P<0.05).ODI score was lower in the MIS-TLIF group than in the AUSS group 3 months after surgery and at the last follow-up(P<0.05).(3)Imaging indices:there was no statistically significant difference in improvement degree of intervertebral space height and intervertebral foramen height between the two groups(P>0.05).The AUSS group depicted superior fusion condition to the MIS-TLIF group(P<0.05),therein the grade Ⅰ fusion rate was higher in the AUSS group.(4)Safety indices:there was no statistically significant difference in the incidence rates of complications and adverse reactions between the two groups(P>0.05).Conclusion In the treatment of lumbar degenerative diseases,AUSS has the advantage of minimally invasive,and the early postoperative pain relief is more obvious.However,the long-term functional improvement of MIS-TLIF is superior.The safety of the two methods is similar,and the clinical choice should be individualized according to the patient's actual conditions.关键词
腰椎退变性疾病/关节镜辅助单孔脊柱手术/微创经椎间孔腰椎椎间融合术/临床效果/安全性Key words
Lumbar degenerative disease/Arthroscopic-assisted uni-portal spinal surgery/Minimally invasive surgery-transforaminal lumbar interbody fusion/Clinical effect/Safety分类
医药卫生
