Department of Orthopaedic Surgery, 457 Hospital of Chinese Peoples' Liberation Army, Wuhan, Hubei Province, China.
J Clin Neurosci. 2011 Jun;18(6):780-3. doi: 10.1016/j.jocn.2010.10.012. Epub 2011 Apr 19.
Between March 2003 and September 2007, 170 consecutive patients with lumbar degenerative disease were studied retrospectively. Eighty patients underwent posterior lumbar interbody fusion (PLIF group) with pedicle screw (PS) fixation, and 82 patients underwent posterolateral fusion (PLF group) with PS fixation. Eight patients were lost to follow-up. The minimum follow-up period in each group was 2.0years. The mean follow-up period for the PLIF group was 3.6years, and for the PLF group, the mean follow-up was 3.4years: there was no significant difference between the two groups for length of follow-up. The Pain Index (PI) improved from 66 to 27 in the PLF group (p<0.001) and from 69 to 29 in the PLIF group (p<0.001), but there was no significant difference between the two groups (p>0.05). In the PLF group, the preoperative mean Oswestry Disability Index (ODI) score was 34.5, which reduced to 14.2 at the final follow-up. In the PLIF group, the mean preoperative ODI was 36.4, which reduced to 16.2 at the final follow-up. There was no significant statistical difference between the two groups for ODI (p>0.05). Eighty-eight percent (n=72) of patients in the PLF group and 91% (n=73) in the PLIF group had radiologically confirmed union, with no significant difference in fusion percentage between the two groups (p>0.05). Twenty-two of 162 patients (14%) underwent a second operation: 18 (22%) in the PLF group and four (5%) patients in the PLIF group (p<0.001). The clinical and functional outcomes in both groups were similar, and no significant difference was found in the parameters tested. Both surgical procedures were effective, but patients in the PLF group showed more complications related to hardware biomechanics than patients in the PLIF group (p<0.001).
2003 年 3 月至 2007 年 9 月，回顾性研究了 170 例连续腰椎退行性疾病患者。80 例患者行后路腰椎间融合术（PLIF 组）加椎弓根螺钉（PS）固定，82 例患者行后路侧方融合术（PLF 组）加 PS 固定。8 例失访。两组的随访时间均不少于 2.0 年。PLIF 组的平均随访时间为 3.6 年，PLF 组的平均随访时间为 3.4 年：两组随访时间无显著差异。PLF 组疼痛指数（PI）从术前的 66 分降至术后的 27 分（p<0.001），PLIF 组从术前的 69 分降至术后的 29 分（p<0.001），但两组间无显著差异（p>0.05）。PLF 组术前 Oswestry 功能障碍指数（ODI）平均为 34.5，末次随访时降至 14.2。PLIF 组术前 ODI 平均为 36.4，末次随访时降至 16.2。两组间 ODI 无显著统计学差异（p>0.05）。PLF 组 88%（n=72）和 PLIF 组 91%（n=73）的患者影像学证实融合，两组间融合率无显著差异（p>0.05）。162 例患者中有 22 例（14%）接受了二次手术：PLF 组 18 例（22%），PLIF 组 4 例（5%）（p<0.001）。两组的临床和功能结果相似，测试参数无显著差异。两种手术均有效，但 PLF 组患者的硬件生物力学相关并发症多于 PLIF 组（p<0.001）。
