CAJ | 학술논문

目的：评估改良经椎间孔腰椎椎间融合术（TLIF）治疗退变性腰椎滑脱（DLS）的临床疗效。方法采用改良TLIF治疗DLS患者32例。手术前后采用Denis疼痛与工作量表评估临床疗效；测量手术前后的腰椎滑脱率、滑脱角、椎间隙高度和腰椎前凸角，并行影像学评估；采用Macnab标准综合评定优良率。结果32例均获随访，时间2～4（2.8±0.2）年。术后Denis疼痛与工作量表分布较术前明显改善（P＜0.05）。术后2～3 d、3个月、6个月和1年的腰椎滑脱率、滑脱角、椎间隙高度、腰椎前凸角均较术前明显改善（P＜0.05）；术后不同时间点的腰椎滑脱率、滑脱角、椎间隙高度、腰椎前凸角比较差异均无统计学意义（P＞0.05）。术后1年影像学检查见椎间及后侧植骨区成熟骨桥生长。Macnab评定：优14例，良16例，可2例，优良率93.8％。结论改良TLIF治疗DLS具有创伤小，能提供理想的复位、满意的临床疗效和融合率。
목적：평고개량경추간공요추추간융합술（TLIF）치료퇴변성요추활탈（DLS）적림상료효。방법채용개량TLIF치료DLS환자32례。수술전후채용Denis동통여공작량표평고림상료효；측량수술전후적요추활탈솔、활탈각、추간극고도화요추전철각，병행영상학평고；채용Macnab표준종합평정우량솔。결과32례균획수방，시간2～4（2.8±0.2）년。술후Denis동통여공작량표분포교술전명현개선（P＜0.05）。술후2～3 d、3개월、6개월화1년적요추활탈솔、활탈각、추간극고도、요추전철각균교술전명현개선（P＜0.05）；술후불동시간점적요추활탈솔、활탈각、추간극고도、요추전철각비교차이균무통계학의의（P＞0.05）。술후1년영상학검사견추간급후측식골구성숙골교생장。Macnab평정：우14례，량16례，가2례，우량솔93.8％。결론개량TLIF치료DLS구유창상소，능제공이상적복위、만의적림상료효화융합솔。
Objective To evaluate the clinical efficacy of modified transforaminal lumbar interbody fusion (TLIF)for the treatment of degenerative lumbar spondylolisthesis(DLS).Methods 32 consecutive patients with DLS were trea-ted with modified TLIF.Clinical outcome was assessed by Denis’pain and work scale,preoperatively and postopera-tively.Radiologic assessment was done by slip rate,slip angle,intervertebral height and lumbar lordosis angle,pre-operatively and postoperatively.Excellent rate was assessed integratedly using Macnab criteria.Results All patients were followed up for 2.8 ±0.2 years (range,2 to 4 years).Denis′pain and work scale after operation were signifi-cant different when compared with preoperative ones (P<0.05 ).At 2~3 days,3 months,6 months and 1 year after operation,the slip rate,slip angle,minimally invasive surgery intervertebral height and lumbar lordosis angle were significantly improved when compared with preoperative ones (P<0.05 ).The slip rate,slip angle,intervertebral height and lumbar lordosis angle showed no significant difference (P>0.05 )at different time points after operation. All patients got bone fusion in the intervertebral and posterior region by radiologic film at 1 year after operation.Ac-cording to the Macnab criteria,14 cases were excellent,16 good,1 fair and the excellent and good rate was 93.8%. Conclusions Modified TLIF is little invasive surgery,and it can afford ideal reduction,satisfactory clinical outcome and union rate.