TLIF治疗老年多节段腰椎间盘突出并椎管狭窄症的临床效果评估

廖国荣 何平 龚翰

【摘要】目的：探讨经椎间孔腰椎-间融合术（TLIF）治疗老年多节段腰椎间盘突出并椎管狭窄症的临床效果。方法：回顾性分析2017年9月至2020年10月期间在我院接受同一名医师治疗的68例老年多节段腰椎间盘突出并椎管狭窄症患者，按照手术方式分为两组，将采用传统后路腰椎间融合術（PLIF）治疗的34例患者归为对照组，将采用TLIF治疗的34例患者归为研究组，比较两组手术相关指标水平、腰椎功能障碍评分、视觉模拟评分、并发症发生情况。结果：与对照组比较，研究组的手术时间、卧床时间更短，且术中出血量、术后引流量更少（P<0.05）；与对照组比较，研究组的VAS、ODI量表评分更低，且并发症发生率也更低（P<0.05）。结论：TLIF可有效缓解老年多节段腰椎间盘突出并椎管狭窄症患者疼痛，改善椎体功能，且具有较高的安全性。

【关键词】TLIF；PLIF；多节段腰椎间盘突出；椎管狭窄症；腰椎功能障碍

[中图分类号]R687.3 [文献标识码]A [文章编号]2096-5249（2021）09-0004-03

Clinical evaluation of TLIF in the treatment of multilevel lumbar disc herniation and spinal stenosis in the elderly

LIAO Guo-rong， HE Ping， GONG Han（Peoples Hospital of Zijin County， Heyuan Guangdong 517400， China）

[Abstract] Objective： To discuss the clinical effect of Transforaminal Lumbar Interbody Fusion （TLIF） for senile multi-segment Lumbar disc herniation and spinal stenosis. Methods： A retrospective analysis in October 2020 and September 2017 - the same physician treated in our hospital during the period of more than 68 elderly cases of segmental Lumbar disc and spinal canal stenosis patients， divided into two groups according to the operation way， using traditional between Posterior Lumbar Fusion， Posterior Lumbar Interbody Fusion PLIF） for the treatment of 34 patients as control group， will use the TLIF treatment of 34 patients were classified as research group， compared two groups of indicators related to the operation level， Lumbar dysfunction score， visual analogue scale， complications occurred. Results： Compared with the control group， the operation time and bed time of the study group were shorter， and the intraoperative blood loss and postoperative drainage volume were less （P<0.05）. Compared with the control group， the VAS and ODI scale scores of the study group were lower， and the incidence of complications was also lower （P<0.05）. Conclusion： TLIF can effectively relieve the pain of elderly patients with multilevel lumbar disc herniation and spinal stenosis， improve the vertebral function， and has a high safety.

[Key words] TLIF； PLIF； Multisegmental lumbar disc herniation； Spinal stenosis； Lumbar dysfunction

腰椎间盘突出通常是指腰椎间盘软骨板、髓核以及纤维环等部位退变，经外力作用下导致纤维环损伤，髓核突出，从而引发椎管狭窄、脊神经或者脊髓压迫，最终诱发肢体麻木、腰痛等症状，该病多发于老年人群[1]。现阶段，临床治疗该病主要以手术干预为主，手术治疗可有效解除神经压迫，减少椎管狭窄，并增强脊柱的稳定性；常用的手术治疗方案主要包括经椎间孔入路腰椎间融合术（Transforaminal Lumbar Interbody Fusion， TLIF）、传统后路腰椎间融合术（Posterior Lumbar Interbody Fusion， PLIF）等[2]。由于部分老年多节段腰椎间盘突出并椎管狭窄症患者机体活动量较低且基础疾病较多，因此，临床需要谨慎选择手术类型[3[。为此，本研究对TLIF治疗老年多节段腰椎间盘突出并椎管狭窄症的临床效果进行分析，报告如下。……