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肥胖型腰椎间盘突出症患者行微创经椎间孔腰椎椎体间融合术与传统后路腰椎椎间融合术的疗效比较。

Comparison of outcomes between minimally invasive transforaminal lumbar interbody fusion and traditional posterior lumbar intervertebral fusion in obese patients with lumbar disk prolapse.

作者信息

Wang Ya-Peng, An Ji-Long, Sun Ya-Peng, Ding Wen-Yuan, Shen Yong, Zhang Wei

机构信息

Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2017 Jan 19;13:87-94. doi: 10.2147/TCRM.S117063. eCollection 2017.

Abstract

OBJECTIVE

The aim of this study was to compare the curative effect between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and the posterior lumbar interbody fusion (PLIF) in obese patients with lumbar disk prolapse.

PATIENTS AND METHODS

In this study, 72 patients who underwent lumbar disk prolapse therapy in the Third Hospital of Hebei Medical University between March 2011 and 2015 were retrospectively analyzed and were divided into two groups, MIS-TLIF group (n=35) and PLIF group (n=37), according to different surgical procedures. Several clinical parameters were compared between these two groups.

RESULTS

Compared with PLIF, MIS-TLIF was associated with longer operative time, less blood loss, less postoperative drainage and shorter postoperative time in bed; moreover, patients in the MIS-TLIF group had lower levels of serum creatine kinase on 1, 3 and 5 postoperative days. At the 3- and 6-month follow-up, Visual Analog Scale (VAS) scores of low back pain of patients in the MIS-TLIF group were significantly reduced and Japanese Orthopaedic Association (JOA) scores were increased, whereas the Oswestry Disability Index (ODI) showed no significant difference between the two groups.

CONCLUSION

Obese patients can achieve good efficacy with MIS-TLIF or PLIF treatment, but MIS-TLIF surgery showed longer operative time, fewer traumas and bleeding volume, less incidence of short-term pain, low complication rate and faster postoperative recovery.

摘要

目的

本研究旨在比较微创经椎间孔腰椎椎间融合术(MIS-TLIF)与后路腰椎椎间融合术(PLIF)治疗肥胖腰椎间盘突出症患者的疗效。

患者与方法

本研究回顾性分析了2011年3月至2015年在河北医科大学第三医院接受腰椎间盘突出症治疗的72例患者,并根据不同手术方式将其分为两组,即MIS-TLIF组(n = 35)和PLIF组(n = 37)。比较两组的多项临床参数。

结果

与PLIF相比,MIS-TLIF手术时间更长,术中出血量更少,术后引流量更少,术后卧床时间更短;此外,MIS-TLIF组患者术后1、3和5天的血清肌酸激酶水平更低。在3个月和6个月随访时,MIS-TLIF组患者的下腰痛视觉模拟量表(VAS)评分显著降低,日本骨科协会(JOA)评分升高,而两组间的Oswestry功能障碍指数(ODI)无显著差异。

结论

肥胖患者采用MIS-TLIF或PLIF治疗均可取得良好疗效,但MIS-TLIF手术时间长,创伤和出血量少,短期疼痛发生率低,并发症发生率低,术后恢复快。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a303/5261601/8e54824ca9e7/tcrm-13-087Fig1.jpg

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