■脊柱手术最常见的病因之一是不稳定型腰椎滑脱(ULS)。要对受影响的结构进行解压缩,同时通过融合保持或恢复稳定性,外科医生利用各种程序。当与椎间融合配对时,后路融合应用最广泛,导致更大的融合率。实施脊柱融合的两种最流行的技术是后路腰椎椎间融合术(PLIF)和经椎间孔腰椎椎间融合术(TLIF)。因此,这两个程序已经过正式评估。
■对通过PLIF和微创(MI)-TLIF接受椎间融合术治疗腰椎管狭窄症的患者进行了回顾性分析。患者随访24个月,融合率,视觉模拟评分(VAS)和Oswestry残疾指数(ODI)以及MacNab临床结果评分,被评估。Bridwell椎间融合分级系统用于评估计算机断层扫描(CT)的融合率。
■对60例ULS患者进行了手术。对33例(55%)(男性14例,女性19例)和27例(45%)(男性11例,女性16例)进行了PLIF。在我们各自队列的87%中,对L4-5或L5-S1水平进行操作。两组的总体融合率相当;然而,TLIF组在VAS方面改进更多,ODI,和MacNab得分。平均而言,MI-TLIF手术时间较长,失血减少。术后MI-TLIF患者比PLIF患者更易移动。
■在文献中得到了充分确立的结果,TLIF提供优于用于ULS或其他脊柱疾病的椎间腰椎融合的其他方法的益处。然而,如果实施MI方法,MI-TLIF可能对患者更有利。在这种情况下,由于操作时间较短,TLIF优于PLIF,减少失血,更快的ODI恢复,更好的MacNab分数,VAS疼痛评分下降幅度更大。
UNASSIGNED: One of the most frequent etiologies for spinal surgery is unstable lumbar spondylolisthesis (ULS). To decompress affected structures while maintaining or restoring stability through fusion, surgeons utilize a variety of procedures. When paired with interbody fusion, posterior fusion is most applied, resulting in greater fusion rates. The two most popular techniques for implementing spinal fusion are posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF). As a result, these two procedures have been assessed formally.
UNASSIGNED: A retrospective analysis of patients who underwent interbody fusion for lumbar stenosis through PLIF and minimally invasive (MI)-TLIF was performed. The patients were followed up for 24 months and fusion rates, Visual Analog Score (VAS), and Oswestry Disability Index (ODI) alongside the MacNab clinical outcome score, were assessed. The Bridwell interbody fusion grading system was used to evaluate fusion rates in computed tomography (CT).
UNASSIGNED: Operations were performed in 60 cases where patients suffered from ULS. PLIF was performed on 33 patients (55%) (14 males and 19 females) and 27 patients (45%) (11 males and 16 females) who underwent MI-TLIF. In 87% of our respective cohort, either the L4-5 or the L5-S1 level was operated on. Overall fusion rates were comparable between the two groups; however, the TLIF group improved more in terms of VAS, ODI, and MacNab scores. On average, MI-TLIF surgery was longer and resulted in reduced blood loss. MI-TLIF patients were more mobile than PLIF patients postoperatively.
UNASSIGNED: With well-established adequate results in the literature, TLIF offers benefits over other methods used for interbody lumbar fusion in ULS or other diseases of the spine. However, MI-TLIF may procure more advantageous for patients if MI methods are implemented. In this instance, TLIF outperformed PLIF due to shorter operating times, less blood loss, faster ODI recovery, better MacNab scores, and a greater decline in VAS pain ratings.