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经皮椎间孔镜下腰椎间融合术与经椎间孔腰椎间融合术治疗伴发腰椎管狭窄的退变性腰椎间盘疾病的比较。

Comparison of PLIF and TLIF in the Treatment of LDH Complicated with Spinal Stenosis.

机构信息

Department of Neurosurgery, Zibo Central Hospital, Zibo 255000, China.

Department of Orthopaedics and Traumatology, Qingdao Hospital of Traditional Chinese Medicine, Hiser Medical Group of Qingdao, Qingdao 266033, China.

出版信息

J Healthc Eng. 2022 Mar 26;2022:9743283. doi: 10.1155/2022/9743283. eCollection 2022.

Abstract

OBJECTIVE

The purpose was to compare the clinical effects of posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar disc herniation (LDH) complicated with spinal stenosis.

METHODS

96 LDH patients complicated with spinal stenosis treated in our hospital (April 2018-April 2020) were chosen as the subjects, and split into the PLIF group and the TLIF group according to different surgical approaches, with 48 cases in each group. The clinical effects of the two groups were compared.

RESULTS

There was no significant difference in hospitalization time between the two groups ( > 0.05). Compared with the PLIF group, the TLIF group had obviously shorter operation time and greatly lesser intraoperative blood loss ( < 0.05). The Numerical Rating Scale (NRS) scores of lower limb pain and low back pain in the two groups at 3 months after surgery were significantly lower than those before surgery ( < 0.001). The Japanese Orthopaedic Association (JOA) scores of the two groups at 3 months after surgery were significantly higher than those before surgery ( < 0.001). The Spitzer Quality of Life Index (SQLI) scores of the two groups at 3 months after surgery were significantly higher than those before surgery ( < 0.001).

CONCLUSION

The two surgical approaches have similar efficacy in treating LDH complicated with spinal stenosis. However, PLIF is better than TLIF in terms of operation time and intraoperative blood loss, which should be adopted as the preferred surgical scheme.

摘要

目的

比较后路腰椎间融合术(PLIF)和经椎间孔腰椎间融合术(TLIF)治疗腰椎间盘突出症(LDH)合并椎管狭窄的临床效果。

方法

选取我院 2018 年 4 月-2020 年 4 月收治的 96 例 LDH 合并椎管狭窄患者,按手术方式不同分为 PLIF 组和 TLIF 组,各 48 例。比较两组临床效果。

结果

两组住院时间比较,差异无统计学意义( > 0.05)。TLIF 组手术时间明显短于 PLIF 组,术中出血量明显少于 PLIF 组,差异均有统计学意义( < 0.05)。两组术后 3 个月下肢疼痛、腰痛的数字评分量表(NRS)评分均明显低于术前,日本骨科协会(JOA)评分均明显高于术前,差异均有统计学意义( < 0.001)。两组术后 3 个月 Spitzer 生活质量指数(SQLI)评分均明显高于术前,差异均有统计学意义( < 0.001)。

结论

PLIF 与 TLIF 治疗 LDH 合并椎管狭窄的疗效相当,但 PLIF 在手术时间、术中出血量方面优于 TLIF,可作为优选的手术方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a0/8976646/8a5fc6f854cf/JHE2022-9743283.001.jpg

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