【摘要】 目的研究微创经椎间孔入路椎体间融合术(minimally invasive surgerytransforaminal lumbar interbody fusion,MIS-TLIF)治疗双节段腰椎退行性疾病中远期疗效。方法选取2013年12月至2015年12月在我科诊治的62例双节段退行性腰椎管狭窄症患者,根据不同手术治疗方法将患者分为MISTLIF组32例和开放经椎间孔入路椎体间融合(open transforaminal lumbar interbody fusion,O-TLIF)组30例。对术后3、6、12、24个月和末次随访(54～72个月)的Oswestry功能障碍指数(Oswestrydisability index,ODI)、疼痛视觉模拟评分(visual analogue scale,VAS)、中远期并发症等进行比较。结果在术后3、6个月时,MIS-TLIF组在腰痛VAS、ODI评分低于O-TLIF组;术后24个月和末次随访时,两组在腰痛VAS评分、下肢痛VAS评分、ODI评分差异均无统计学意义;在末次随访时,两组在VAS评分和ODI评分较术前均明显下降。邻椎病:MIS-TLIF组4例,O-TLIF组5例;椎体间融合率:MIS-TLIF组92.2%,O-TLIF组88.3%。结论 MIS-TLIF治疗双节段退行性腰椎管狭窄症创伤小、恢复快、中远期疗效满意且并发症发生率低。更多还原

【Abstract】 Objective To study the mid-and long-term clinical efficacy of minimally invasive transforaminal lumbar interbody fusion for the treatment of double-segment lumbar spinal stenosis.Methods Sixty-two patients with double-segment lumbar spinal stenosis who were treated in our hospital from Dec2013 to Dec2015 were retrospectively analyzed.These patients were divided into two group,MIS-TLIF group(32 patients) and O-TLIF group(30 patients).Oswestry disability index(ODI),visual analog scale(VAS)were compared between the two groups at 3 months,6 months,12 months,24 months after surgery and the latest follow-up.Complications and intervertebral fusion rate were also analyzed.Results Compared to O-TLIF group,MIS-TLIF group showed a significant decrease in lumbar VAS and ODI at 3 months and 6 months after surgery,but the difference was not significant between the two groups at 12 months,24 months and the latest follow-up.Both the two groups showed an obvious decrease in VAS and ODI at latest follow up compared to pre-operation.Adjacent segment degeneration was observed in 4 and 5 patients in MIS-TLIF and O-TLIF group respectively.The fusion rate in MIS-TLIF was92.2%,and 88.3% for O-TLIF group.Conclusion MIS-TLIF treatment fordouble-segment lumbar spinal stenosis can obtain excellent medium and long-term outcomes,and this methoddose not increase the incidence of medium and long-term complications.更多还原