| Objective:To analyze and compare the clinical efficacy of posterior open surgery(PLIF)and minimally invasive surgery(MIS-TLIF)combined with percutaneous pedicle screw in the treatment of lumbar spondylolisthesis,so as to provide references for further clinical application of minimally invasive surgery.Methods:There are 58 patients in this group,and allcases were collected from orthopaedic department of Shanxi Dayi Hospital Affliated to Shanxi Medical University of 2007-2009.There were 31 cases in the open group,including 9 males and 22 females。There were 23 cases of L4 and 8 cases of L5.There were 27 cases in the minimally invasive group,including 6 males and 21 females.There were 18 cases of L4 and 9 cases of L5.AlI the 58 cases were single-level desease.The operation time,the amount of intraoperative bleeding,the postoperative flow rate,the time of hospitalization and complications were recorded.The VAS scores of low back pain were recorded before and 3 days,3 months and 6months after operation.The ODI scores of the two groups were recorded before and3 months,6 months after operation.The curative effect was evaluated and the height recovery of the intervertebral space was compared between the two groups before and after operation.Results:There was no significant difference between the minimally invasive group and open group in gender,age and slippage section;In the minimally invasive group,the operative time was 154.63 ± 41.07 min,the intraoperative blood loss was 120.37 ± 68.30 ml,the postoperative drainage volume was 175.26 ± 128.04 ml,the catheterization time was 2.63 ± 0.74 d,and the hospitalization time was 10.44±1.95 d.In the open group,the operative time was 132.42 + 35.70 min,the intraoperative blood loss was 342.90 +178.87 ml,the postoperative drainage volume was 573.32 + 180.83 min,the catheterization time was 4.68 + 1.22 d,and the hospitalization time was11.97 ± 2.85 d.There were statistical differences between the two groups in the operation time(P<0.05),the amount of bleeding in the operation,the flow rate after operation and the time of catheterization,and the minimally invasive group was lower than that in the open group.In the operation time,the minimally invasive group was higher than the open group.In the minimally invasive group,the VAS score of low back pain before operation was 6.56 + 1.53,3 days after operation was 2.89 + 1.05,3 months after operation was1.48 + 1.05,6 months after operation was 0.96 + 0.71,preoperative ODI score was 47.56+ 4.81,3 months after operation was 4.81%,and 6 months after operation was 16.29±1.74.In the the open group,the VAS score of low back pain before operation was 7.10 +1.27,3 days after operation was 4.90 + 0.94,3 months after operation was 1.71 + 0.82,6months after operation was 1.19 + 0.60,preoperative ODI score was 49.13 ± 2.33,3months after operation was 24.48±2.57,and 6 months after operation was 16.29±1.74.There was no significant difference between the two groups in preoperative and postoperative 3 months,6 months VAS score and ODI score(P>0.05).There was a significant difference in VAS score on the 3 day after operation(P<0.05),and the minimally invasive group was lower than that of the open group.There was no significant difference in the height of the intervertebral space and the slip percentage between the two groups before and after the operation and the incidence of complications(P>0.05).Conclusion:MIS-TLIF operation is equivalent to PLIF in the treatment of lumbar spondylolisthesis.MIS-TLIF has obvious advantages in reducing the amount of bleeding in the operation,shortening the time of hospitalization and alleviating postoperative pain. |
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