Abstract: ［Abstract］ Objective To compare the clinical efficacy and safety of minimally invasive surgery transforaminal lumbar interbody fusion（MIS?TLIF）in Quadrant minimally invasive channel system and conventional posterior lumbar interbody fusion （PLIF） in the treatment of degenerative lumbar spinal stenosis in the elderly. Methods From June 2013 to January 2017 in our hospital for treatment of 90 cases of lumbar spinal stenosis in elderly patients as the research object. Among them , 54 patients were operated by MIS?TLIF procedure（MIS?TLIF group）, and 36 patients were treated with PLIF operation （PLIF group）. The surgical effects of two groups were compared. The operation time, the amount of bleeding, the bed time, the amount of blood transfusion and the flow rate after the operation were compared between the two groups. The clinical symptoms of two groups were compared , and the incidences of adverse reactions in the two groups were compared. Results The cure rate and total effective rate in the MIS-TLIF group were significantly higher than those in the PLIF group （P<0.05）. The operative time in the MIS?TLIF group was significantly higher than that in the PLIF group , and the intraoperative blood loss, bed rest time, postoperative blood transfusion volume and postoperative drainage volume were significantly lower than those in the control group（P<0.05）. The JOA score in 6 months after operation in two groups was both higher than that in 1day before preoperative, VAS score and ODI score were lower than these in one day before preoperative（P<0.05）. The JOA score in the MIS-TLIF group in 6 months after operation was higher than that in the PLIF group in 6 months after operation, and the VAS score and ODI score were lower than those in the control group in 6 months after operation （P<0.05）. The incidences of postoperative infection and hard capsule rupture and the total adverse reaction incidences in the MIS?TLIF group were significantly lower than those in the PLIF group（P<0.05）. Conclusion MIS-TLIF minimally invasive surgery under Quadrant minimally invasive channel system for degenerative lumbar spinal stenosis in elderly patients with significant effect , small trauma and rapid recovery.

Key words: degenerative lumbar spinal stenosis, elderly, minimally invasive, MIS?TLIF

摘要： ［摘要］ 目的 比较Quadrant 微创通道系统下微创经椎间孔入路腰椎椎体间融合（MIS?TLIF）手术与经后路腰椎椎间融合术（PLIF）手术治疗的临床疗效及安全性。方法 选取 2013 年 6 月～2017 年1 月在本院接受治疗的90 例退变性腰椎管狭窄症老年患者作为研究对象，其中54 例患者采用MIS?TLIF 手术（MIS?TLIF 组）；36 例采用PLIF 手术（PLIF 组）。比较两组患者手术疗效，比较两组患者手术时间、术中出血量、卧床时间、术后输血量、术后引流量等手术指标，比较两组患者术后临床症状改善情况，并比较两组患者不良反应发生情况。结果 MIS?TLIF 组手术后痊愈率和总有效率均显著高于 PLIF 组（P<0.05）。MIS?TLIF 组手术时间显著高于 PLIF 组，术中出血量、卧床时间、术后输血量、术后引流量均显著低于 PLIF 组（P<0.05）。两组患者术后 6 个月JOA 评分较术前 1 d 升高，VAS 评分、ODI 评分均较术前 1 d 降低（P<0.05）。MIS?TLIF 组术后 6个月 JOA 评分较 PLIF 组术后 6 个月升高，VAS 评分、ODI 评分均较 PLIF 组术后 6 个月降低（P<0.05）。MIS?TLIF 组术后感染发生率、硬囊破裂发生率和总不良反应发生率均显著低于 PLIF 组（P<0.05）。结论 从当前的资料反映出 Quadrant 微创通道系统下 MIS?TLIF 手术治疗老年退变性腰椎管狭窄症效果显著、创伤小且恢复快。

关键词: 微创, MIS?TLIF, 老年人, 退变性腰椎管狭窄症