首页|全内镜与微创经椎间孔腰椎椎间融合术治疗腰椎退行性疾病的临床效果对比

全内镜与微创经椎间孔腰椎椎间融合术治疗腰椎退行性疾病的临床效果对比

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目的:比较全内镜经椎间孔腰椎椎间融合术(FE-TLIF)和微创经椎间孔腰椎椎间融合术(MI-TLIF)治疗腰椎退行性疾病(LDD)的临床效果和安全性.方法:前瞻性将 2020 年 1 月—2022 年10 月在百色市人民医院因LDD接受TLIF治疗的患者 60 例,按随机数字表法分为FE-TLIF组(接受FE-TLIF治疗)和MI-TLIF组(接受MI-TLIF治疗),每组 30 例.比较两组的围手术期指标、术前和术后 3 个月疼痛视觉模拟评分法(VAS)评分与Oswestry功能障碍指数(ODI)评分、术后 6 个月及 1 年椎体间融合情况.结果:两组手术时间比较,差异无统计学意义(P＞0.05).FE-TLIF组术中透视次数多于MI-TLIF组,差异有统计学意义(P＜0.05).FE-TLIF组术中出血量少于MI-TLIF组,术后卧床时间、住院时间均短于MI-TLIF组,差异均有统计学意义(P＜0.05).两组患者术后VAS评分及ODI评分与术前比较均明显降低,差异均有统计学意义(P＜0.05).术后 6 个月及 1 年两组椎体间融合情况比较,差异均无统计学意义(P＞0.05).两组术后并发症发生率比较,差异无统计学意义(P＞0.05).结论:FE-TLIF与MI-TLIF在术后疼痛缓解、功能恢复、融合率方面显示出了相似的结果,但FE-TLIF在降低术中出血量,缩短术后卧床时间、住院时间上有更大优势.
Comparison of Clinical Effects of Full Endoscopic and Minimally Invasive Transforaminal Lumbar Interbody Fusion in the Treatment of Lumbar Degenerative Diseases
Objective:To compare the clinical efficacy and safety of full endoscopic transforaminal lumbar interbody fusion(FE-TLIF)and minimally invasive transforaminal lumbar interbody fusion(MI-TLIF)in the treatment of lumbar degenerative diseases(LDD).Method:A total of 60 patients who received TLIF for LDD in Baise People's Hospital from January 2020 to October 2022 were prospectively randomized into FE-TLIF group(received FE-TLIF treatment)and MI-TLIF group(received MI-TLIF treatment),with 30 patients in each group.Perioperative indexes,visual analogue scale(VAS)scores and Oswestry disability index(ODI)scores before and 3 months after surgery,interbody fusion 6 months and 1 year after surgery were compared between the two groups.Result:There was no significant difference in operation time between the two groups(P＞0.05).The number of intraoperative fluoroscopy in FE-TLIF group was higher than that in MI-TLIF group,the difference was statistically significant(P＜0.05).The intraoperative blood loss in FE-TLIF group was less than that in MI-TLIF group,and the postoperative bed time and hospital stay were shorter than those in MI-TLIF group,the differences were statistically significant(P＜0.05).Postoperative VAS scores and ODI scores of two groups were significantly lower than those before surgery,the differences were statistically significant(P＜0.05).There were no significant differences in interbody fusion between the two groups at 6 months and 1 year after surgery(P＞0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P＞0.05).Conclusion:FE-TLIF and MI-TLIF show similar results in postoperative pain relief,functional recovery,and fusion rate,but FE-TLIF has greater advantages in reducing intraoperative blood loss,shortening postoperative bed duration,and shortening hospital stay.

Lumbar degenerative diseasesFull endoscopic transforaminal lumbar interbody fusionMinimally invasive transforaminal lumbar interbody fusion

李新武、韦华成、李昊、廖正文、魏芳芳

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百色市人民医院脊柱骨病外科 广西 百色 533000

南宁市第一人民医院骨关节科 广西 南宁 530000

百色市人民医院麻醉科 广西 百色 533000

腰椎退行性疾病 全内镜经椎间孔腰椎椎间融合术 微创经椎间孔腰椎椎间融合术

广西自然科学基金广西卫生健康委自筹课题百色市科学研究与技术开发计划

2023GXNSFBA026203Z-L2023181020230586

2024

10.3969/j.issn.1674-4985.2024.08.009

中国医学创新
中国保健协会

中国医学创新

影响因子：1.706
ISSN：1674-4985
年,卷(期)：2024.21(8)
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