两种不同腰椎椎间融合联合椎弓根螺钉固定治疗腰椎滑脱症方法的比较研究

[Comparative study on two different methods of lumbar interbody fusion with pedicle screw fixation for the treatment of spondylolisthesis].

作者信息

Yan Deng-Lu, Li Jian, Gao Liang-Bin, Soo C L

机构信息

Department of Orthopedics, Third Affiliated Hospital of Guangzhou Medical College, Guangzhou 510150, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Apr 1;46(7):497-500.

PMID:18785557

Abstract

OBJECTIVE

To compare the clinical outcome of transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) with pedicle screw fixation on the treatment of spondylolisthesis.

METHODS

One hundred and twenty patients with spondylolisthesis who were managed in our department were retrospectively evaluated. They were categorized into TLIF group and PLIF group according to the surgical methods, with 60 cases in each group. The slippage rate, the height of intervertebral space and intervertebral foramen were measured in each patient before and after operation and were compared between the two groups correspondingly. The interbody fusion rate, JOA score and complications after operation were also determined.

RESULTS

All the 120 patients were followed up for an average of 23 months (range, 16 to 35 months). Interbody bony fusion was achieved in every case and cage excursion or subsidence occurred in not any case. JOA score was rated as good or excellent in 83.3% of the TLIF cases and in 81.7% of the PLIF cases. There were no difference between the two groups (P > 0.05). Postoperative slippage rate was significantly less than preoperative ones in both groups (P < 0.01). No difference in lost of reduction at the final follow-up was found between TLIF and PLIF groups (P > 0.05). Significant increases in the height of intervertebral space and intervertebral foramen after operation were approved in both groups (P < 0.01), but no difference in these increases was confirmed between the two groups (P > 0.05). The lost of the height of intervertebral space and intervertebral foramen at the final follow-up were also similar between the two groups (P > 0.05).

CONCLUSIONS

TLIF and PLIF are good methods for the treatment of spondylolisthesis, both leading to satisfactory clinical outcomes. However, TLIF is relatively safer owing to its unilateral approach for interbody fusion.

摘要

目的

比较经椎间孔腰椎椎体间融合术（TLIF）与后路腰椎椎体间融合术（PLIF）联合椎弓根螺钉固定治疗腰椎滑脱症的临床疗效。

方法

回顾性分析我科收治的120例腰椎滑脱症患者。根据手术方式将其分为TLIF组和PLIF组，每组60例。分别测量每位患者术前及术后的滑脱率、椎间隙高度及椎间孔高度，并在两组间进行相应比较。同时确定椎体间融合率、日本骨科学会（JOA）评分及术后并发症。

结果

120例患者均获随访，平均随访时间为23个月（范围16至35个月）。所有病例均实现椎体间骨性融合，无一例出现椎间融合器移位或下沉。TLIF组83.3%的病例JOA评分评定为良好或优秀，PLIF组为81.7%。两组间差异无统计学意义（P>0.05）。两组术后滑脱率均显著低于术前（P<0.01）。TLIF组与PLIF组在末次随访时复位丢失情况差异无统计学意义（P>0.05）。两组术后椎间隙高度及椎间孔高度均显著增加（P<0.01），但两组间增加幅度差异无统计学意义（P>0.05）。两组在末次随访时椎间隙高度及椎间孔高度丢失情况也相似（P>0.05）。