目的评价经后路椎间融合术（posterior lumbar interbody fusion，PLIF）与经椎间孔椎间融合术（transforaminal lumbar interbody fusion，TLIF）治疗腰椎退行性疾病的疗效。方法分析2012—12—2015—06应用PLIF和TLIF治疗腰椎退行性疾病患者73例，比较两组患者的手术时间、术中出血量、术后引流量、手术并发症及椎间融合效果；比较两组病例组内及组间术前、术后6个月的腰痛VAS（Visual Analogue Score）评分、Oswestry功能障碍指数调查表（The Oswestry Disability Index，ODI）评分。结果PLIF组手术时间、术中出血量及术后引流量均较TuF组高；PLIF组及TLIF组腰痛VAS评分术后6个月较术前均明显改善，两组组间比较术前腰痛VAS评分无明显差异，术后6个月腰痛VAS评分PLIF组较TLIF组高，差异有统计学意义；两组术后6个月较术前ODI评分明显改善，组间比较术前及术后ODI评分无明显差异。结论两种手术方法均可以有效缓解腰椎退行性疾病的症状，TLIF在手术时间、失血量及并发症的发生上都较PLIF低，对于单侧症状患者可选择TLIF的手术方式，对于双侧压迫患者可选用PMF技术。
Objective To compare the clinical effect of posterior lumbar interbody fusion （PLIF） and transforaminal lumbar interbody fusion （TLIF） in the treatment of degenerative lumbar disease. Methods 73 patients with degenerative lumbar disease who were treated by PLIF or TLIF were selected from December 2012 to June 2015. The operation time, average blood loss, postoperative drainage volume, incidence of complications and the effect of fusion were compared between the two groups. The visual analogue score （VAS） of lumbago and the Oswestry disability index （ODI） were also compared between the two groups. Results The operation time, average blood loss volume and postoperative drainage volume of PLIF group were significantly higher than those in the TLIF group. The VAS score of lumbago was improved in the two groups compared with preoperation. There was no significant difference in VAS score of lumbago before operation between the two groups. However, the VAS score of lumbago was significantly better in the TLIF group than that in the PLIF group at six months postoperatively. ODI of the latest follow up was significantly lower than preoperation in both two groups. Whereas,there were no significant differences neither at preoperation nor at six months postoperation between the two groups. Conclusion Both methods are effective in relieving symptoms, but TLIF can be preferred for its shorter operative time, less blood loss, and less incidence of complications. Thus, the TLIF procedure is available for cases with single-sided pathologies and the PLIF procedure is available for bilateral compressions.
The Journal of Cervicodynia and Lumbodynia
posterior lumbar interbody fusion
transforaminal lumbar interbody fusion
degenerative lumbar disease