多节段经椎间孔腰椎椎间融合术治疗退行性腰椎管狭窄的疗效OA

Objective To investigate the efficacy of multi-level transforaminal lumbar interbody fusion(TLIF)in the treatment of degenerative lumbar spinal stenosis.Methods A retrospective analysis was conducted on the clinical data of 120 patients with degenerative lumbar spinal stenosis who were hospital-ized in the Department of Orthopedics at our hospital between December 2020 and December 2023.All patients had concomitant lumbar instability,lumbar scoliosis(Cobb's angle≥10°),spondylolisthesis(Meyerding grade≥Ⅰ),or intervertebral disc herniation.According to the surgical approaches,patients were divided into an observation group and a control group.The observation group included 60 patients who underwent spi-nal decompression combined with multi-level TLIF.The control group included 60 patients who underwent spinal decompression combined with multi-level posterior lumbar interbody fusion(PLIF).The two groups were compared in terms of clinical efficacy,pain intensity,lumbar function,radiographic parameters of lumbar mor-phology,and complication rates.Results All patients in both groups recovered uneventfully.At the 6-month postoperative follow-up,the excellent/good rate of the observation group was 88.33%(53/60),which was higher than 75%(45/60)of the control group(P<0.05).At both1 month and6 months postoperatively,the pain visual analog scale(VAS)in both groups were significantly lower than preoperative values,and the re-duction was significantly greater in the observation group(P<0.05).Similarly,Japanese Orthopaedic Association(JOA)scores for lumbar function at 1 and 6 months postoperatively were improved compared to preoperative lev-els in both groups,with the degree being greater in the observation group(P<0.05).For intragroup comparisons,at 6 months postoperatively,the Cobb angle,transverse plane angle(TPA),and sagittal vertical axis(SVA)were significantly lower,while lumbar lordosis(LL)was significantly higher than the preoperative values in both groups(all P<0.05).No significant differences were found in thoracic kyphosis(TK)before and after surgery in either group(P>0.05).For intergroup comparisons,there were no significant differences in all parameters between the two groups preoperatively(P>0.05).At 6 months postoperatively,the observation group exhibited significantly lower Cobb angle,TPA,and SVA than the control group(all P<0.05),whereas no significant difference was observed in TK or LL between the two groups(P>0.05).Conclusion Multi-level TLIF is effective in the treatment of degenerative lumbar spinal stenosis who meet the surgical indications.It significantly improves clinical outcomes,alleviates pain,and promotes recovery of lumbar function.