Observation On Clinical Results Of PLIF And TLIF Surgical Treatment In Degenerative Lumbar Disease

Objective:This study is to explore and evaluate the therapeutic effect of posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) surgical treatment in degenerative lumbar disease.Methods:A retrospective study was performed, and 72 cases of PLIF and TLIF surgical treatment in degenerative lumbar disease were collected from the traumatic orthopaedics department of Qilu hospital from May,2009 to Dec, 2010.There were 39 cases of PLIF and 33 cases of TLIF. Compare the mean operative time,blood loss,bone fusion rate,intervertebral space height change and the score by using the JOA score low back pain rating, the Oswestry disability index and the VAS of the preoperative and postoperative to evaluate the surgical results.Results:The operative time of PLIF group was longer than TLIF group's,and there was significant difference (P<0.05).And the blood loss of the PLIF group was more than TLIF group's,and there was significant difference(P<0.05).The average preoperative intervertebral space height in the PLIF group improved from 7.567±0.9639 preoperatively to 11.903±1.1753 post operatively, respectively. At last follow up there was minimal lost of correction down to 11.741±1.1688, respectively. Similarly in the TLIF group, preoperative intervertebral space height were improved from 7.43±1.1072 to 11.633±1.1129 immediately post operative. At last follow up minimal lost of correction was noted with average intervertebral space height of 11.495±1.0715. Both techniques achieve statistical significance in restoration of intervertebral space height (P<0.01); however, there was no statistical difference between the two techniques(P>0.05).The bone fusion rate of the two groups both were 100%,and there were no difference. There were 21 cases of excellent,15 cases of good,3 cases of general, and 0 cases of poor results in PLIF group.There were 20 cases of excellent,11 case of good,2 case of general, and 0 cases of poor results in TLIF group. The JOA score in all patients was 93.1% of good or excellent (92.3% in PLIF and 93.9% in TLIF).The final follow-up scores of JOA, ODI and VAS were better than the preoperative scores(P< 0.01). But the final follow-up results showed no statistically significant difference (P>0.05). No serious complications occurred.Conclusion:Both PLIF and TLIF are viable methods in the treatment of degenerative lumbar disease. According to the patients'frondose condition,we should strictly control the indictions of PLIF and TLIF, and select the better method.