关键词: 腰椎滑脱症, 椎弓根螺钉固定, 经椎间孔椎体间融合, 后路腰椎椎体间融合

Abstract: Objective To compare the therapeutic effect of transforminal lumbar interbody fusion（TLIF）with posterior lumbar interbody fusion（PLIF）in treatment of lumbar spondylolisthesis.Methods From March 2010 to March 2014，a total of 62 patients suffering from lumbar spondylolisthesis were divided into 2 groups.36 patients in group underwent TLIF.26 patients in group underwent PLIF.Posterolateral fixation with pedicle screw and decompression，interbody fusion through TLIF or PLIF technical combined with cage for distraction reduction.The application of statistics analysis of the indicators compared between the two groups，including operating time，blood loss and volume of drainage after operation.VAS，ODI evaluating standards were applied to evaluate the therapeutic effect.The intervertebral height and bone fusion were observed by X ray.Results All patients underwent surgery safely without severe complications occurred.2 cases occurred dural tear and 1 of nerve root injury in PLIF group.There was no significant difference in general materials and operation time between TLIF group[（134.17±27.40）min] and PLIF group[（130.38±30.00）min] （P>0.05）.The blood during operation，volume of drainage after operation of TLIF group were significantly less than PLIF（P<0.05）.The average following up time was 20 months（12～48 months）in TLIF group and 18 months（9～42 months）in PLIF group.Compared with preoperative parameters，the scores of VAS and ODI decreased significantly after surgery and at the final followup in both groups（P<0.05）.But there was no significantly difference between TLIF and PLIF in VAS and ODI score（P>0.05）.It occurred cage dislocation with no nerve symptom in PLIF group in 1 cases.1 case of fat liquefaction of incision injure happened in TLIF group.At the followup after 6.5 months postoperatively，the fusion is 94.4% in TLIF and 92.3% in PLIF，and no broken screw.Conclusion TLIF and PLIF technical both have a good clinical results in the treatment of lumbar spondylolisthesis which can achieve stable and effective decompression.With a less invasive and a less rate of nerve injury compared with PLIF，TLIF procedure can be performed easily and better protection the structure with less complications.

Key words: lumbar spondylolisthesis, pedicle screw fixation, transforaminal lumbar interbody fusion, posterior lumbar interbody fusion