摘要
目的比较分析Wiltse与后正中入路经椎间孔腰椎椎体间融合术(TLIF)治疗腰椎间盘突出症(LDH)的安全性及近期效果。方法回顾性分析2019-01—2022-12于郑州大学第二附属医院骨一科行TLIF治疗的86例LDH患者的临床资料,根据手术入路方式分为Wiltse组(38例)和后正中组(48例)。比较2组患者的基线资料。记录手术时间、术中出血量、下床活动时间。评估术前、术后6个月患者的腰椎功能JOA评分和数字评定量表(NRS)评分。结果2组患者的基线资料差异无统计学意义(P>0.05)。Wiltse组的手术时间、下床活动时间均短于后正中组,术中出血量少于后正中组,差异均有统计学意义(P<0.05)。术前2组患者的JOA、NRS评分差异均无统计学意义(P>0.05);术后6个月时,Wiltse组患者的JOA评分高于后正中组,NRS评分低于后正中组,差异均有统计学意义(P<0.05)。2组患者的并发症发生率差异无统计学意义(P>0.05)。结论经Wiltse入路与后正中入路实施TLIF,均有良好的安全性和近期效果。但Wiltse入路改善腰椎功能、缓解疼痛的效果更佳,且手术时间短、术中出血量少,更利于患者术后康复。
Objective To compare and analyze the safety and short-term effects of Wiltse and posterior median approach transforaminal lumbar interbody fusion(TLIF)for the treatment of lumbar disc herniation(LDH).Methods A retrospective analysis was conducted on 86 patients with LDH who underwent TLIF treatment in the Department of Orthopedics at the Second Affiliated Hospital of Zhengzhou University from January 2019 to December 2022.The patients were divided into the Wiltse approach group(Wiltse group,38 patients)and the posterior median approach group(posterior median group,48 patients)according to the surgical approach.The baseline data of the two groups were compared,and the operation time,intraoperative blood loss,and time to ambulation were recorded.The lumbar spine function before and 6 months after surgery were evaluated,and the Japanese Orthopaedic Association(JOA)score and Numeric Rating Scale(NRS)score were compared.Results There was no significant difference in baseline data between the two groups(P>0.05).The operation time and time to ambulation in the Wiltse group were shorter than those in the posterior median group,and the intraoperative blood loss was less than that in the posterior median group,with statistical significance(P<0.05).There was no significant difference in JOA and NRS scores between the two groups before surgery(P>0.05).At 6 months after surgery,the JOA score in the Wiltse group was higher than that in the posterior median group,and the NRS score was lower than that in the posterior median group,with statistical significance(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Both Wiltse and posterior median approaches TLIF can improve lumbar spine function and relieve pain in patients with LDH,and they are both safe.However,the Wiltse approach TLIF has better effects in improving lumbar spine function and relieving pain,with shorter operation time and less intraoperative blood loss,which is beneficial for postoperative rehabi
作者
郭淼勇
张明生
来秋山
高文飞
Guo Miaoyong;Zhang Mingsheng;Lai Qiushan;Gao Wenfei(The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)
出处
《河南外科学杂志》
2024年第3期28-30,共3页
Henan Journal of Surgery
