Comparison of Mini-TLIF using quadrant minimally invasive system and open-TLIF in treatment of lumbar disc herniation
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摘要: 目的 比较和分析微创Quadrant通道下椎间孔椎间融合术(TLIF)与开放TLIF两种手术方式治疗腰椎间盘突出症的临床效果,以期能够找到最为合适的TLIF手术方式。 方法 对2011—2014年诊断为腰椎间盘突出症并行TLIF手术的共计186例患者进行回顾性分析。其中Quadrant通道下TLIF组为102人,开放TLIF手术组为84人。经过术后严谨的随访,记录患者的手术时间、切口长度、出血量、引流量等一般性指标,并对患者手术前后的VAS疼痛评分、MacNab手术疗效、OSWESTRY功能障碍指数评定(ODI)及融合率等进行统计和比较。 结果 微创Quadrant通道下TLIF组较开放TLIF组在切口长度、术中出血量、术后引流量、术后住院时间等一般性指标中都有明显的优势(P<0.05),而在手术时间上2组差异无统计学意义(P>0.05)。微创组在术后的VAS疼痛评分中优于开放组,而在术后6个月时,2组之间差异无统计学意义。在手术疗效及功能的比较中2组之间差异无统计学意义。术后6个月开放TLIF组的融合率高于微创TLIF组,但差异无统计学意义(P>0.05)。 结论 微创TLIF手术具有明显的微创手术优点如出血少、创伤小,并在临床治疗效果上与开放TLIF手术之间并无明显差异,是一种可靠的手术方法,为腰椎间盘突出症的治疗提供了一个新的选择。Abstract: Objective To compare the clinical effect and safety of the Mini-TLIF using quadrant minimally invasive system or Open-TLIF in patients with lumbar disc herniation,and to find the most appropriate operative treatment of TLIF. Methods We retrospectively reviewed 186 patients with lumbar disc herniation who were treated in ousr hospital from 2011 to 2014.A total of 102 patients underwent Mini-TLIF and 84 underwent Open-TLIF.The clinical outcomes were evaluated by the operation time,length of incision,amount of bleeding and volume of drainage afteroperation.ODI,VAS,modified Macnab criteria and fusion rate between two groups were also compared. Results There were significantly advantage in Mini-TLIF group in length of incision,amount of bleeding and volume of drainage after operation(P<0.05),but no difference in operation time.The VAS score in Mini-TLIF group was significantly better after the operation but no difference in 6 months after the operation.There was no significantly difference between the two groups in ODI,lumbar function and the fusion though the fusion rate in Open-TLIF group was higher than Mini-TLIF. Conclusion Mini-TLIF has obvious advantages in some aspects like less operation trauma,blood less and satisfied short-term effect in the treatment of lumbar disc herniation,which could be a new choice and be further carried out in the clinical work.
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