【摘要】 目的探讨椎间孔入路腰椎融合术(TLIF)与后路椎间融合术(PLIF)在腰椎退行性疾病治疗中对患者术后神经功能恢复的影响。方法 224例腰椎退行性疾病患者根据手术方式分为TLIF组(n=98)及PLIF组(n=126),对比2组临床效果、术后神经功能损伤及术后3个月时神经功能JOA评分。结果 2组有效率(TLIF组90.8%,PLIF组89.7%)比较差异无统计学意义(P>0.05);TLIF组术后神经根损伤发生率5.1%,显著低于PLIF组的19.8%(P<0.01);2组术前JOA评分比较差异无统计学意义(P>0.05),术后均显著增高(P<0.01),术后1周TLIF组显著高于PLIF组(P<0.01),术后3个月2组比较差异无统计学意义(P>0.05)。结论 TLIF与PLIF在腰椎退行性疾病的外科治疗中均具有良好效果,虽然手术方式不同,但术后远期神经功能恢复情况并无明显区别,应密切结合病人的病情选择合适的手术方式。更多还原

【Abstract】 Objective To discuss the influence of TLIF and PLIF on postoperative neurologic recovery in patients with lumbar degenerative disease.Methods 224 patients with lumbar degenerative disease were divided into the TLIF group(n=98)and the PLIF group(n=126),then the clinical results,postoperative neurological injury and JOA score 3months postoperative were contrasted between the two groups.Results There was no significantly difference in the effective rate(TLIF group90.8% and PLIF group 89.7%)between the two groups(P>0.05);the incidence of postoperative neurologic injury in the TLIF group was 5.1%,significantly lower than 19.8%in the PLIF group(P<0.01);there was no significantly difference in JOA score preoperation(P>0.05),but significantly improved 1week after the surgery in the two groups(P<0.01),and TLIF group was significantly higher than the PLIF group(P<0.01),no significantly difference between the two groups 3months after the surgery(P>0.05).Conclusion TLIF and PLIF have good results in patients with lumbar degenerative diseases,although different surgical methods,but there is no significant difference between the long-term postoperative recovery of neurological function,and therefore should be closely combined with the patient’s condition to select the appropriate surgical approach.更多还原