Abstract: Objective To study and compare the clinical efficacy of minimally invasive surgery transforaminal lumbar interbody fusion （MIS-TLIF） and transforaminal lumbar interbody fusion （TLIF） in the treatment of single-segment lumbar spinal stenosis. Methods Sixty patients with single-segment lumbar spinal stenosis admitted to our hospital between January 2016 and December 2020 were selected as the research subjects, and they were divided into study group （n=30） and control group （n=30） by using the randomized control method. Study group received MIS-TLIF surgery, and control group was given TLIF surgery. The differences in the perioperative related indicators and scores of lumbar Oswestry Dysfunction Index （ODI） and Visual Analogue Scale （VAS） before surgery and at different time points after surgery were compared between the two groups of patients. Blood was collected to determine the changes in laboratory indicators such as serum interleukin-6 （IL-6）, interleukin-10 （IL-10）, creatine kinase （CK） and C-reactive protein （CRP） before and after surgery. Results The duration of surgery in study group was longer than that in control group （P<0.05）, and the intraoperative blood loss, postoperative drainage volume, postoperative ambulation time and discharge time were all less or shorter than those in control group （P<0.05）. The ODI scores of patients in study group at different time points after surgery were lower than those in control group （P<0.05）. The VAS scores of study group were lower than those of control group at different time points after surgery （P<0.05）. The expression levels of serum IL-6, IL-10, CK and CRP of study group after treatment were lower than those of control group （P<0.05）. Conclusion MIS-TLIF has a high safety in the treatment of patients with single-segment lumbar spinal stenosis, and can shorten the postoperative recovery time, improve lumbar function and pain symptoms, relieve the degree of postoperative muscle injury and promote the recovery of inflammatory indicators.

Key words: Minimally invasive surgery transforaminal lumbar interbody fusion, Transforaminal lumbar interbody fusion, Lumbar spinal stenosis, Clinical effect

摘要： 目的 研究比较微创经椎间孔入路腰椎椎间融合术（MIS-TLIF）与经椎间孔腰椎椎间融合术（TLIF）治疗单节段腰椎管狭窄症的临床疗效。方法 使用便利抽样法选取我院2016年1月~2020年12月收治的单节段腰椎管狭窄症患者60例作为研究对象,根据接受的手术方法将患者分为对照法将其分为MIS-TLIF组（n=30例）和TLIF组（n=30例）。比较两组患者围手术期相关指标差异、术前与术后不同时间腰椎Oswestry功能障碍指数（ODI）及视觉模拟评分法（VAS）评分差异,采血测定手术前后血清白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肌酸激酶（CK）及C反应蛋白（CRP）等实验室指标变化。结果 研究组患者手术持续时间长于对照组（P<0.05）,术中出血量、术后引流量、术后下床时间及出院时间均小于对照组（P<0.05）;术后不同时间研究组患者ODI评分均低于对照组（P<0.05）;术后不同时间研究组患者VAS评分均低于对照组（P<0.05）;治疗后研究组患者血清IL-6、IL-10、CK及CRP表达水平低于对照组（P<0.05）。结论 MIS-TLIF术在治疗单节段腰椎管狭窄症患者中应用安全性更高,缩短患者术后恢复时间并改善其腰椎功能及疼痛症状,减轻术后肌肉损伤程度,促进患者炎症指标恢复。

关键词: 微创经椎间孔入路腰椎椎间融合术, 经椎间孔腰椎椎间融合术, 腰椎管狭窄, 临床效果