Wang Wei, Guo Zhao, Yang Lixin, Liu Jianning, Li Zhiyong, Li Jiaqi, Zhao Hong, Sun Tao
Department of Orthopedics, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, China.
Department of Orthopedics, Affiliated Hospital of Hebei University, Baoding, Hebei, China.
Front Surg. 2025 May 13;12:1598531. doi: 10.3389/fsurg.2025.1598531. eCollection 2025.
The purpose of this study is to discuss the safety and effectiveness of transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar disc herniation.
From August 2018 to December 2021, patients with lumbar disc herniation who received TLIF treatment were included in this study. Clinical data collected during both the preoperative period and the 2-year postoperative follow-up were analyzed. The correlations between preoperative clinical indicators and postoperative functional outcomes were modeled using both univariate regression and multivariable-adjusted analyses.
The study population comprised 547 consecutive cases (male: 261, 47.7%; female: 286, 52.3%). Stratified outcome analysis showed 458 patients (83.7%) attained optimal surgical recovery without detectable morbidity, contrasted with 89 cases (16.3%) manifesting postoperative complications. The univariate analysis of postoperative complications found that the recurrence of symptoms was related to body mass index (BMI), preoperative pain time, High-level segment, intraoperative bleeding volume and postoperative visual analog scale (VAS)-back. Postoperative hematoma was related to hypertension and wound drainage. Poor wound healing was related to BMI and Wound drainage volume. However, this study failed to find the related factors of wound infection. After binary logistic analysis of the above single factors, we found that BMI and preoperative pain time were independent risk factors for symptom recurrence, and BMI were independent risk factors for Poor wound healing.
Transforaminal lumbar interbody fusion surgery can safely and effectively treat lumbar disc herniation.
本研究旨在探讨经椎间孔腰椎椎体间融合术（TLIF）治疗腰椎间盘突出症的安全性和有效性。
纳入2018年8月至2021年12月接受TLIF治疗的腰椎间盘突出症患者。分析术前及术后2年随访期间收集的临床资料。采用单因素回归和多变量调整分析对术前临床指标与术后功能结局之间的相关性进行建模。
研究人群包括547例连续病例（男性：261例，47.7%；女性：286例，52.3%）。分层结局分析显示，458例患者（83.7%）获得了最佳手术恢复且无明显并发症，相比之下，89例患者（16.3%）出现了术后并发症。术后并发症的单因素分析发现，症状复发与体重指数（BMI）、术前疼痛时间、高位节段、术中出血量和术后视觉模拟评分（VAS）背部有关。术后血肿与高血压和伤口引流有关。伤口愈合不良与BMI和伤口引流量有关。然而，本研究未发现伤口感染的相关因素。对上述单因素进行二元逻辑分析后，我们发现BMI和术前疼痛时间是症状复发的独立危险因素，BMI是伤口愈合不良的独立危险因素。
经椎间孔腰椎椎体间融合手术能够安全有效地治疗腰椎间盘突出症。
