Uludag University Faculty of Medicine, Department of Orthopaedics and Traumatology, Bursa/Nilüfer, Turkey.
Uludag University Faculty of Medicine, Department of Anesthesiology and Intensive Care, Bursa/Nilüfer, Turkey.
J Int Med Res. 2020 Apr;48(4):300060520910025. doi: 10.1177/0300060520910025.
This study was performed to compare fusion rates and clinical outcomes of posterior decompression by posterolateral fusion (PLF) versus transforaminal lumbar interbody fusion (TLIF) for treatment of lumbar spinal stenosis.
This retrospective cohort study involved 157 patients with lumbar spinal stenosis treated with PLF alone or instrumented PLF combined with TLIF from 2010 to 2018. The patients were divided into two groups: the PLF group (Group A), in which posterior decompression with instrumented PLF was performed, and the cage-augmented group (Group B), in which TLIF was added to the procedures described for the PLF group. Patient outcomes (Oswestry Disability Index, visual analog scale score, and 36-Item Short-Form Health Survey scores) and fusion rates were compared.
The fusion rate was similar between the two groups. Among patients with two- and three-level fusion, improvements in the clinical outcome scores were significantly greater in Group B than Group A.
Combining TLIF with PLF provides better clinical outcomes than PLF alone when multilevel fusion is indicated. TLIF augmentation does not improve the fusion rates in either single- or multi-level surgery.
本研究旨在比较后路减压经旁侧融合（PLF）与经椎间孔腰椎间融合术（TLIF）治疗腰椎管狭窄症的融合率和临床结果。
本回顾性队列研究纳入了 2010 年至 2018 年间接受单纯 PLF 或后路减压 PLF 联合 TLIF 治疗的 157 例腰椎管狭窄症患者。患者分为两组：后路减压 PLF 组（A 组）和 TLIF 增强组（B 组），A 组行后路减压 PLF，B 组在 A 组手术基础上联合 TLIF。比较两组患者的结局（Oswestry 功能障碍指数、视觉模拟评分和 36 项简明健康调查量表评分）和融合率。
两组的融合率相似。在接受二、三平面融合的患者中，B 组的临床结局评分改善明显大于 A 组。
对于多节段融合，TLIF 联合 PLF 比单纯 PLF 能提供更好的临床结果。TLIF 增强并不能提高单节段或多节段手术的融合率。
