摘要
目的:观察不同手术方法治疗退变性腰椎滑脱合并腰椎管狭窄症的疗效比较分析。方法:将我院2012年1月-2019年6月收治退变性腰椎滑脱合并腰椎管狭窄症患者总计138例,根据患者手术方案进行分组,其中实施以经椎间孔入路腰椎间融合术(transforaminal lum-bar interbody fusio,TLIF)患者73例设置为对照组,另实施以微创下经椎间孔入路的腰椎椎间融合术(minimally invasive transforaminal lumbar interbody fu-sion,MIS-TLIF)患者65例设置为观察组。对照2组围术期指标,术前、术后随访疼痛VAS评分、Oswestry功能障碍指数,治疗后疗效,术后1个月、术后6个月时的生活质量评分。结果:观察组患者术中出血量少于对照组,手术、术后首次下床与住院时长均短于对照组(P<0.05)。在术前2组患者疼痛VAS评分、Oswestry功能障碍指数相比(P>0.05)。而在术后3.6、12个月比较,观察组低于对照组(P<0.05)。观察组治疗后优良率为83.08%,高于对照组的68.49%(P<0.05)。观察组治疗后可率为15.38%、差率为1.54%,低于对照组的26.03%5.48%(P>0.05)。而观察组术后并发症率为3.08%,低于对照组的12.33%(P<0.05)。在手术后6个月时2组患者WHOQOL-100评分明显较手术后1个月时升高,其中观察组患者的WHOQOL-100的各项评分明显高于对照组(P<0.05)。结论:在退变性腰椎滑脱合并腰椎管狭窄症实施以MIS-TLIF手术,可较为明显的减少术中出血量,缩短术后首次下床与住院时间,减轻术后疼痛与腰部功能障碍,治疗优良率更高,生活质量提升,效果理想。
Objective:To observe the ffcacy of different surgical methods in the treatment of degenerative lum-bar spondylolisthesis combined with lumbar spinal stenosis.Methods:A total of 138 patients with degenerative lum-bar spondylolisthesis complicated with lumbar spinal stenosis were treated in our hospital(from January 2012 to June 2019).They were divided into groups according to the operation plan.Among them,73 patients who underwent transforaminal lumbar-bar interbody fusion(TLIF)were set as group t,In addition,65 patients who underwent minimally invasive transforaminal lumbar interbody fusion(mis-tlif)were set as mis-t group.The perioperative in-dexes,pain VAS score,Oswestry dysfunction index,curative effect after treatment,quality of life score at 1 month and 6 months after operation were compared between the two groups.Results:The amount of intraoperative bleeding in mis-t group was less than that in T group,and the length of first getting out of bed and hospitalization after opera-tion were shorter than that in T group P.The pain VAS score and Oswestry dysfunction index of the two groups were compared before operation(P>0.05).Al3/6/12 months afier operation,mis-t group was lower than t group(PO.05).The excellent and good rate of mis-t group(83.08%)was higher than that of T group(68.49%),(P0.05).The recovery rate(15.38%)and difference rate(1.54%)in mis-t group were lower than those in T group(26.03%)and(5.48%),(P>0.05).The postoperative complication rate of mis-t group(3.08%)was.lower than that of T group(12.33%),(P>O.05).At 6 months after operation,the WH0Q0L-100 score of patients in the two groups was significantly higher than that at 1 month after operation.Among them,the WHOQOL-100 scores of patients in mis-I group were significantly higher than those in T group(P<0.05).Conclusion:The im-plementation of mis-tlif in degenerative lumbar spondylolisthesis combined with lumbar spinal stenosis can signifi-cantly reduce the amount of intraoperative bleeding,shorten the first time out of bed and hospital stay,reduce
作者
姚东元
陆禹严
黄德征
YAO Dong-yuan;LU Yu-yan;HUANG De-zheng(Department of spinal osteopathy,Yulin first peoples hospital Guangxi,Yulin,Guangxi 537000)
出处
《中国伤残医学》
2022年第9期1-5,共5页
Chinese Journal of Trauma and Disability Medicine
关键词
不同手术方法
退变性腰椎滑脱
腰椎管狭窄症
治疗疗效
Different surgical methods
Degenerative lumbar spondylolisthesis
Lumbar spinal stenosis
Therapeutic effect
