CAJ | 학술논문

目的：比较经传统腰椎间孔椎间融合术( TLIF)与改良TLIF治疗老年外侧腰椎间盘突出症的临床疗效。方法选取50例外侧腰椎间盘突出症的老年患者为研究对象，随机分为观察组和对照组各25例，对照组采用传统TLIF手术治疗，观察组采用改良TLIF手术治疗，比较两组患者的术中情况、术后疼痛改善及恢复情况。结果与对照组比较，观察组手术时间短，术中出血量低，术后下床时间短，费用少(P<0．01)。手术3个月后，两组患者VAS评分及JOA评分均较术前有明显改善(P<0．01)，两组间比较差异无统计学意义(P>0．05)。术后随访12个月，两组患者植骨融合率差异无统计学意义(P>0．05)，但观察组JOA改善分级优于对照组(P<0．05)。结论改良TLIF降低了术中对于椎旁软组织的破坏，手术时间短，创伤小，且术后稳定性更高。
목적：비교경전통요추간공추간융합술( TLIF)여개량TLIF치료노년외측요추간반돌출증적림상료효。방법선취50예외측요추간반돌출증적노년환자위연구대상，수궤분위관찰조화대조조각25례，대조조채용전통TLIF수술치료，관찰조채용개량TLIF수술치료，비교량조환자적술중정황、술후동통개선급회복정황。결과여대조조비교，관찰조수술시간단，술중출혈량저，술후하상시간단，비용소(P<0．01)。수술3개월후，량조환자VAS평분급JOA평분균교술전유명현개선(P<0．01)，량조간비교차이무통계학의의(P>0．05)。술후수방12개월，량조환자식골융합솔차이무통계학의의(P>0．05)，단관찰조JOA개선분급우우대조조(P<0．05)。결론개량TLIF강저료술중대우추방연조직적파배，수술시간단，창상소，차술후은정성경고。
Objective To compare clinical efficacy of traditional transforaminal lumbar interbody fusion ( TLIF) with modified TLIF treatment in elderly lateral lumbar disc herniation. Methods 50 cases of lateral lumbar disc hernia-tion in elderly patients were randomly divided into observation group and control group. 25 patients were in the control group using traditional TLIF surgery, observation group were treated with improved TLIF surgery, the two groups were compared surgery pain improved, intraoperative and postoperative recovery. Results The observation group was compared with the control group, which showed shorter operative time, blood loss decreased, ambulation after a short time, reduced costs ( P<0. 01 ) . 3 months after surgery, the two groups of patients′ VAS scores and preoperative JOA scores were significantly improved ( P<0. 01 ) , but there was no significant difference between the two groups (P>0. 05). Patients were followed up for 12 months, the rate of fusion patients were not significantly different (P>0. 05), but the observation group were better than the control group in JOA improved classification (P <0. 05). Conclusions Modified TLIF reduces the paraspinal soft tissue surgery destruction, trauma and has shorter operative time, and postoperative higher stability.