导航下微创PLIF与传统PLIF治疗腰椎退变性疾病疗效比较

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Abstract Objective To compare the clinical effect on MIS-PLIF by navigation with traditional PLIF by navigation for single segmental lumbar degenerative diseases.Methods Clinical data about 106 patients with single-level lumbar degenerative diseases were retrospectively analyzed in our department from June 2014 to May 2017.42 cases (group A) underwent MIS decompression，posterior lumbar interbody fusion，percutaneous pedicle screw fixation assisted by navigation with average age of 54.3 years old (21～72).There were 24 males and 18 females，and 20 cases of lesions located in L_4～5segments，22 cases of L₅ S₁ segments.The other 64 cases (group B) underwent traditional open decompression，posterior lumbar interbody fusion assisted by navigation with average age of 56.7 years old (23～74).There were 33 males and 31 females，and 30 cases of lesions located in L_4～5 segments，34 cases of L₅ S₁ segments.The operative time，X-ray exposure times，blood loss，postoperative ambulation and complications were compared between two groups.Furthermore，visual analogue scores (VAS) and X-ray examination were used to assess the clinical outcomes.Results All the patients were followed up，and no complications such as infection，cerebrospinal fluid leakage (CSF leak) and nerve injury happened in both groups.Group A had longer operative time and X-ray exposure times than group B (P＜0.05)，but less blood loss during operation and after operation than group B (P＜0.05).There was no significant difference between the two preoperative VAS scores (P＜0.05).The VAS scores for low backache at 5th day and two weeks postoperative in group A was better than group B (P＜0.05)，but the scores was no statistical difference between two groups at 12 months postoperative.No difference for the VAS scores of leg pain was noted between two groups.Additional，there were significant differences (P＜0.01) for the VAS scores of low backache and leg pain between two groups at 5th day and two weeks and 12 months postoperative compared with preoperative. Conclusion Treatment of single segmental lumbar degenerative disease，navigation assisted MIS-PLIF can alleviate the symptoms of patients with low backache and leg pain as well as open PLIF by navigation.Similarly，both types of surgery can be safely and effectively.In addition，as for the low backache，intraoperative blood loss，postoperative bed time，MIS group is superior than open group.

Key words： retrospective study single segment lumbar spinal fusion joint minimally invasive technology treatment effect

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