| 李卫勤,韩 康,杨智泉,党培业,祁 健,王彦东.单双边固定在MIS-TLIF治疗双节段腰椎间盘突出症患者中的疗效比较分析[J].,2017,17(34):6701-6704 |
| 单双边固定在MIS-TLIF治疗双节段腰椎间盘突出症患者中的疗效比较分析 |
| Clinical Outcomes and Cost Analysis for Unilateral Versus Bilateral Pedicle Screw Fixation in Two Levels during Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) for Degenerative Spondylolisthesis Patients |
| 投稿时间：2017-05-24 修订日期：2017-06-20 |
| DOI：10.13241/j.cnki.pmb.2017.34.021 |
| 中文关键词: MIS-TLIF 临床疗效 椎弓根固定 腰椎退行性疾病 |
| 英文关键词: MIS-TLIF Clinical outcomes Pedicle screw fixation Degenerative spondylolisthesis |
| 基金项目:国家自然科学基金项目(31500856)；济南军区总医院院长基金项目（2015ZX01） |
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| 中文摘要: |
| 摘要 目的：探讨和比较单双边固定在腰椎退行性疾病患者MISTLIF术后的临床疗效、影像学比较及并发症。方法：回顾性分析经纳入和排除标准筛选后，自2012.01-2016.01在我院就诊且行MISTLIF手术的患者共计96人。上述患者均行双节段的（L4/5及L5/S1）减压手术。按照固定方式的不同，将其分为双边固定组（bilateral pedicle screw，BPS)及单边固定组（unilateral pedicle screw，UPS)组。双边组纳入患者52人，单边组纳入患者44人。所有患者均至少给予至少1年的术后随访。观察和比较他们的疼痛（VAS），ODI值，融合率，并发症，术中情况等指标。结果：两组患者在各种基线资料的比较中未发现显著统计学差异。与双边固定组（BPS）相比，单边固定组（UPS）在手术时间，出血量，X线暴露次数等方面具有显著优势(P<0.05)。两组患者在术后的VAS疼痛评分、ODI值均显著优于术前且两组间无统计学差异(P>0.05)。两组单双边固定组的患者在术后12个月的融合率、并发症等指标的比较中未见显著性差异(P>0.05)。结论：在疼痛、ODI等临床疗效指标及并发症的比较中，单边固定和双边固定在MIS-TLIF术后无显著性差异。但在手术时间、出血量，X线暴露次数等方面，在MIS-TLIF手术中使用单边固定更具有显著的优势，在临床中可能是一种更好的选择。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the clinical, radiological outcomes and complication of unilateral pedicle screw (UPS) versus bilateral pedicle screw (BPS) in degenerative lumbar diseases after MIS-TLIF. Methods: In this study, we retrospectively analyzed 96 consecutive patients who had two-level MIS-TLIF at L4/L5 and L5/S1 from January 2012 to January 2016 and the clinical and radiological outcome and the complication were compared. Of the 96 patients for analysis, 44 patients underwent unilateral fixation, and 52 patients underwent bilateral fixation. All patients received at least 12 months fellow up. Clinical outcomes were evaluated by VAS, ODI, fusion rate, operation idex and complication. Results: There was no statistically significant difference in baseline demographic characteristics between the two groups (P>0.05). There was a significantly longer operating time, more blood loss and X-ray exposure times in BPS comparing with UPS (P<0.05). Clinical outcomes in two groups such as the pain (VAS) and Oswestry Disability Index (ODI) improved significantly after surgery (P<0.05) and no difference was found between them (P>0.05). No significant difference was found in fusion rate and total complication rate between the two groups (P>0.05). Conclusion: There was no significant difference between the two fixation methods of MIS-TLIF in clinical outcomes and complications. However, unilateral pedicle screw has some superiorities such as shorter operating time, lower cost, less blood loss and X-ray exposure. Unilateral pedicle screw might be more suitable in performing two-level pedicle screw fixation after MIS-TLIF. |
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