[1]张同会,李涛,唐谨,等.两种不同介质的微创融合术治疗单节段腰椎退变性疾病的临床研究[J].中国中医骨伤科杂志,2025,33(11):51-57.[doi:10.20085/j.cnki.issn1005-0205.251110]
　ZHANG Tonghui,LI Tao,TANG Jin,et al.Clinical Study of Minimally Invasive Surgery in the Treatment of Single-Segment Lumbar Degenerative Disease with Two Different Media[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(11):51-57.[doi:10.20085/j.cnki.issn1005-0205.251110]
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两种不同介质的微创融合术治疗单节段腰椎退变性疾病的临床研究()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年11期
页码:
51-57
栏目:
临床研究
出版日期:
2025-11-15

文章信息/Info

Title:
Clinical Study of Minimally Invasive Surgery in the Treatment of Single-Segment Lumbar Degenerative Disease with Two Different Media
文章编号:
1005-0205(2025)11-0051-07
作者:
张同会1; 2; 李涛2; 唐谨2; 戢鹏2; 黄荷2; 赵宙2; 徐峰1△
1湖北中医药大学针灸骨伤学院(武汉,430070)
2武汉中西医结合骨科医院(武汉体育学院附属医院)
Author(s):
ZHANG Tonghui1; 2; LI Tao2; TANG Jin2; JI Peng2; HUANG He2; ZHAO Zhou2; XU Feng1△
1School of Acupuncture and Orthopedics,Hubei University of Chinese Medicine,Wuhan 430070,China; 2Wuhan Hospital of Integrated Chinese and Western Medicine Orthopedics(Affiliated Hospital of Wuhan Sports University),Wuhan 430070,China.
关键词:
单节段腰椎退变性疾病;  经皮内镜下后路腰椎融合术;  可扩张通道辅助下腰椎后路融合术
Keywords:
single level lumbar degenerative disease;  percutaneous endoscopic posterior lumbar interbody fusion;  minimally invasive posterior lumbar interbody fusion
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.251110
文献标志码:
A
摘要:
目的:比较水介质下经皮内镜后路腰椎融合术(PE-PLIF)与空气介质下可扩张通道辅助的后路腰椎融合术(MIS-PLIF)的临床疗效。方法:回顾性分析自2021年11月至2024 年1月采用微创融合技术治疗的单节段腰椎间盘突出症患者58例,其中行PE-PLIF手术30例,行MIS-PLIF手术28例。统计两组患者基本资料、围手术期临床数据和影像学参数,通过视觉模拟量表(VAS)评分和 Oswestry功能障碍指数(ODI)评分评估临床结果。结果:两组患者均顺利完成手术,无严重并发症发生,所有患者均随访12个月。与MIS-PLIF组相比,PE-PLIF组手术时间长、切口长度短、术中出血量少、术后引流量少、隐性失血量少、术后至下床时间短,差异均有统计学意义(P<0.05); 比较切口愈合等级及下肢深静脉血栓的发生率,差异无统计学意义(P>0.05)。出院时随访PE-PLIF组VAS 评分及ODI评分优于MIS-PLIF组,差异有统计学意义(P<0.05)。影像学表现与术前相比,术后6 个月和末次随访时,两组患者椎间隙高度、腰椎前凸角均显著增加,差异有统计学意义(P<0.05),相应时间点两组间的差异均无统计学意义(P>0.05)。此外,相应时间点两组间 Bridwell 融合分级差异也无统计学意义(P>0.05)。结论:PE-PLIF手术较MIS-PLIF手术损伤更小,出血量少,术后恢复快,近期腰椎功能恢复更佳,远期疗效相当。
Abstract:
Objective:To compare the effects of percutaneous endoscopic posterior lumbar interbody fusion(PE-PLIF)with aqueous media and minimally invasive posterior lumbar interbody fusion(MIS-PLIF)assisted by expandable channel under air medium.Methods:A retrospective analysis was conducted on 58 cases of single-level lumbar disc herniation treated with a minimally invasive fusion technique from November 2021 to January 2024,of which 30 cases underwent PE-PLIF and 28 cases underwent MIS-PLIF.The basic data,perioperative clinical data,and radiological parameters of the two groups were statistically analyzed.The clinical outcomes were assessed using the visual analogue scale(VAS)and Oswestry disability index(ODI)scores.Results:All procedures were successfully completed without major complications,with 12 months follow-up.The PE-PLIF group demonstrated significantly longer operative time but superior outcomes in incision length,blood loss(intraopera-tive/postoperative/hidden),and earlier ambulation versus MIS-PLIF(all P<0.05).No intergroup differences existed in wound healing or deep vein thrombosis(DVT)incidence(P>0.05).At discharge,PE-PLIF showed better VAS and ODI scores(P<0.05).Both groups exhibited improved intervertebral space height and lordosis postoperatively(P<0.05 vs preoperative),with no intergroup differences at any follow-up(P>0.05).Furthermore,there was no notable disparity in Bridwell fusion grade between the two groups at corresponding time points(P>0.05).Conclusion:The PE-PLIF technique offers the benefits of reduced surgical trauma,decreased blood loss,accelerated postoperative recovery,and improved short-term restoration of lumbar function,and similar long-term efficacy to MIS-PLIF.

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(收稿日期:2025-06-25)

备注/Memo

备注/Memo:
△通信作者 E-mail:gkxf79390@sohu.com
更新日期/Last Update: 2025-11-15