摘要
目的比较单侧双通道内镜下经椎间孔腰椎间融合术(UBE-TLIF)与微创通道下经椎间孔腰椎间融合术(MIS-TLIF)治疗腰椎滑脱症的疗效。方法将62例腰椎滑脱症患者根据手术方法不同分为UBE-TLIF组(30例)和MIS-TLIF组(32例)。比较两组手术指标、疼痛VAS评分、ODI、SF-36评分、椎间隙高度(IH)、Cobb角和腰椎前凸角(LL)、椎间融合及并发症发生情况。结果患者均获得随访,UBE-TLIF组随访12~18个月,MIS-TLIF组随访12~19个月。手术时间UBE-TLIF组长于MIS-TLIF组(P<0.05)。术中出血量、住院时间UBE-TLIF组少(短)于MIS-TLIF组(P<0.05)。IH、Cobb角及LL:末次随访两组均较术前改善(P<0.05),两组比较差异均无统计学意义(P>0.05)。腰、腿痛VAS评分及ODI、SF-36评分:两组末次随访均较术前改善(P<0.05),其中腰、腿痛VAS评分及SF-36评分两组比较差异均无统计学意义(P>0.05),而ODI UBE-TLIF组低于MIS-TLIF组(P<0.05)。术后6个月植骨融合率两组比较差异无统计学意义(P>0.05),末次随访时两组均达到植骨融合。两组术后均未出现硬脊膜撕裂、脊髓硬膜外血肿、神经根损伤及感染等并发症。结论MIS-TLIF和UBE-TLIF治疗腰椎滑脱症均能获得良好的临床疗效,但是UBE-TLIF具有术中出血少、住院时间短等优点。
Objective To compare the efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion(UBE-TLIF)and minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)for treatment of lumbar spondylolisthesis.Methods Sixty-two patients with lumbar spondylolistheses were divided into two groups according to the different surgical methods,including UBE-TLIF group(30 cases)and Mis TLIF group(32 cases).The surgical indicators,pain VAS,ODI,SF-36 scores,intervertebral height(IH),Cobb angle and lumbar lordosis(LL),interbody fusion and complications were compared between the two groups.Results All patients were followed up,the time was 12~18 months in UBE-TLIF group,and 12~19 months in MIS-TLIF group.Compared with MIS-TLIF group,UBE-TLIF group had a longer operation time,but less intraoperative blood loss and shorter hospital stay(P<0.05).IH,Cobb angles and LL:at the last follow-up,two group were improved than the preoperation(P<0.05),there were no statistical differences between the two groups(P>0.05).Pain VAS of low back pain and leg pain,ODI and SF-36 scores:the two groups were improved than before operation(P<0.05),of which the pain VAS of the low back and legs and SF-36 scores had no statistical differences between the two groups(P>0.05),while ODI in UBE-TLIF group was lower than that in MIS-TLIF group(P<0.05).There was no statistical difference in bone grafting fusion rate between the two groups at 6 months after surgery(P>0.05),all patients achieved bone fusion at the last follow-up.No complications such as dural tear,spinal epidural hematoma,nerve root injury and infection occurred in the two groups after operation.Conclusions Both MIS-TLIF and UBE-TLIF can achieve good clinical efficacy for treatment of lumbar spondylolisthesis,but UBE-TLIF has the advantages of less intraoperative bleeding and shorter hospital stay.
作者
潘丹
唐少龙
刘超
付军初
陈思远
黄庆华
PAN Dan;TANG Shao-long;LIU Chao;FU Jun-chu;CHEN Si-yuan;HUANG Qing-hua(Dept of Spinal Surgery,Zhuzhou Hospital Affiliated of Xiangya School of Medicine,Central South University,Zhuzhou,Hunan 412000,China)
出处
《临床骨科杂志》
2024年第2期181-185,共5页
Journal of Clinical Orthopaedics
基金
湖南省自然科学基金(编号:2023JJ60444)
湖南省卫健委科研计划项目(编号:C2017074)。
关键词
单侧双通道内镜
经椎间孔腰椎间融合术
腰椎滑脱
unilateral biportal endoscopic
transforaminal lumbar interbody fusion
lumbar spondylolisthesis
