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目的:比较经椎间孔入路(MIS-TLIF)与经椎板间入路(PE-PLIF)行腰椎融合术治疗腰椎退行性疾病的临床疗效。方法:选择2021年3月—2023年3月就诊于宜昌市中心人民医院的74例腰椎退行性疾病患者,根据手术方式不同,分为PE-PLIF组(n=33)和MIS-TLIF组(n=41),观察两组患者术后3天、1个月、6个月及12个月的视觉模拟量表(VAS)评分及Oswestry功能障碍指数(ODI)。术后12个月采用改良MacNab标准评价疗效,根据Bridwell椎间融合标准评价椎间融合情况。结果:与MIS-TLIF组相比,PE-PLIF组手术切口长度[(13.25±0.97) mm vs(30.62±3.78) mm]、住院时间[(3.21±1.11) d vs (8.98±1.99) d]及术后引流量[(66.21±10.23) mL vs (141.17±16.53) ml]均明显降低(均P<0.05)。PE-PLIF组患者术后3天、1个月和6个月腰痛VAS评分及术后3天和1个月腿痛VAS评分均显著低于MIS-TLIF组(均P<0.05);PE-PLIF组患者术后1个月ODI显著低于MIS-TLI组[(20.85±3.86)%vs(24.65±3.60)%](P<0.05);术后12个月两组患者疗效优良率、椎间融合情况及并发症发生情况无明显差异(均P>0.05)。结论:与MIS-TLIF相比,PE-PLIF在腰椎退行性疾病患者中具有创伤小、疼痛轻及恢复快等优势,值得在临床推广应用。
Abstract：Objective:To compare the clinical efficacy of the minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) and percutaneous endoscopic posterior lumbar interbody fusion(PE-PLIF) in the treatment of lumbar degenerative diseases.Methods:A total of 74 patients with lumbar degenerative diseases treated at Yichang Central People ' s Hospital between March 2021 and March 2023 were retrospectively analyzed.Based on the surgical approach,patients were divided into the PE-PLIF group(n=33) and the MIS-TLIF group(n=41).Visual analog scale(VAS) scores and Oswestry disability index(ODI) were recorded at 3 days,1 month,6 months,and 12 months postoperatively.At 12 months postoperatively,clinical efficacy was evaluated using the modified MacNab criteria,and intervertebral fusion status was assessed based on the Bridwell fusion grading system.Results:Compared with the MIS-TLIF group,the PE-PLIF group had significantly shorter incision length [(13.25 ± 0.97) mm vs(30.62 ±3.78) mm],shorter hospital stay [(3.21 ± 1.11) d vs(8.98±1.99) d],and reduced postoperative drainage volume [(66.21 ± 10.23) mL vs(141.17 ± 16.53) mL](all P <0.05).VAS scores for low back pain at3 days,1 month and 6 months,VAS scores for leg pain at 3 days and 1 months posloperalively were significantly lower in the PE-PLIF group compared to the MIS-TLIF group(all P < 0.05).The ODI at1 month postoperatively was also significantly lower in the PE-PLIF group [(20.85±3.86)% vs(24.65 ±3.60) %](P<0.05).At 12 months postoperatively,there were no significant differences between the two groups in terms of excellent and goid rate of therapeutic efficacy,intervertebral fusion rates,or incidence of complications(all P> 0.05).Conclusion:Compared with MIS-TLIF,PE-PLIF offers the advantages of smaller surgical trauma,less postoperative pain,and faster recovery in patients with lumbar degenerative diseases,which is worthy of broader clinical application.
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基本信息:
中图分类号:R687.3
引用信息:
[1]刘丰平,阿里木·马木提,赵浩,等.经椎间孔入路和经椎板间入路行腰椎融合术治疗腰椎退行性疾病的临床疗效分析[J].巴楚医学,2025,8(03):23-28.
基金信息:
湖北省教育厅科学技术研究计划指导性项目(Z2021228/B2021028)
2025-09-28
2025-09-28