Abstract: ［Abstract］ Objective To analyze and compare the outcomes in treatment of single level lumbar spondylolisthesis for Wiltse IV with MIS?TLIT （minimally invasive transforaminal lumbar interbody fusion， MIS?TLIT group） under a microscope and PLIF （posterior lumbar interbody fusion， PLIF group）. Methods This was a retrospective study and analyzed the clinical data of 128 cases of patients with single level lumbar spondylolisthesis for Wiltse IV. The perioperative indicators between the two groups （intraoperative blood loss， operative time， postoperative wound drainage for 48 hours after surgery） were recorded and compared. VAS score， JOA score and ODI score at preoperative levels， and in 2 weeks， 3， 6 and 24 months after surgery respectively were compared between MIS?TLIT group and PLIF group during the two years of follow?up. Results There was no significant difference between MIS?TLIT group and PLIF groups in operative time（P>0.05）. The intraoperative blood loss， postoperative wound drainage for 48 hours after surgery in MIS?TLIF were significantly lower than in PLIF group（P<0.05）. The significant differences were showed in VAS and ODI score between two groups and the patients in MIS?TLIF group were significantly lower than in PLIF group， but the JOA score of MIS?TLIF group was higher than that of PLIF group in 2 weeks after operation （P<0.05）. The differences of VAS， JOA score and ODI score between two groups were no significant differences in 3， 6， 24 months after operation（P<0.05）. Conclusion Compared with PLIF， microscopical MIS?TLIF treatment of single level lumbar spondylolisthesis for Wiltse IV has less trauma， less blood loss， significant short?term curative efficacy and similar long?term efficacy.

Key words: spondylolisthesis, microscope, minimal invasive posterior transforaminal lumbar interbody fusion, posterior lumbar interbody fusion, efficacy

摘要： ［摘要］ 目的 分析比较显微镜下MIS?TLIT（微创经椎间孔腰椎椎体间融合术）与PLIF（后路腰椎椎体间融合术）对单节段Wiltse IV型腰椎滑脱症的临床治疗。方法 收集128例单节段Wiltse IV型腰椎滑脱症患者的临床资料。比较两组患者围手术期指标（术中出血量、手术时间、术后48小时伤口引流量），术后2周、3、6、24月规律随访，随访时采用Visual Analogue Scores（VAS）评分、日本骨科协会（JOA）评分以及（Osestry disability index）ODI功能障碍评分对比手术疗效。结果 与行PLIF患者比较，行MIS?TLIT的患者手术时间无统计学意义（P>0.05）；术中出血量以及术后48小时伤口引流量较低，比较差异有统计学意义（P<0.05）；行MIS?TLIT的患者术后2周随访的腰疼VAS评分、ODI功能障碍得分低，JOA评分高于行PLIF的患者，比较差异有统计学意义（P<0.05），然而术后随访3、6、24月比较差异无统计学意义（P>0.05）。结论 与PLIF比较，显微镜下MIS?TLIT治疗单节段Wiltse IV型腰椎滑脱症创伤小，出血量少，短期疗效显著，长期疗效相仿。

关键词: 后路腰椎椎体间融合术, 滑脱, 微创经椎间孔腰椎椎体间融合术, 疗效, 显微镜