关键词: 腰椎滑脱； 微创手术； 后入路； 腰椎融合

Abstract: Objective analyze the clinical efficacy of percutaneous endoscopic lumbar posterior fusion(PE-PLIF) in the treatment of lumbar spondylolisthesis and evaluate its safety and effectiveness.Methods From January 2018 to December 2021,46 patients with grade Ⅰ degenerative lumbar spondylolisthesis underwent PE-PLIF surgery in the Department of Orthopedics of our hospital.General data such as age,gender,body mass index(BMI),operative time,blood loss and fluoroscopy were collected.Visual analogue scale(VAS) and Oswestry Disability Index(ODI) scores were compared before surgery,3 days and 12 months after surgery to analyze the efficacy.Macnab was used to evaluate patient satisfaction,and Lenke was used to evaluate fusion.Follow-up was 1.2 to 3.3 years.Results The average operative time of the patients was (143.76±34.39)min,the average intraoperative fluoroscopy was (6.98±0.75)times,and the average hospitalization was (9.13±3.68)days.The VAS scores before low back pain ranged from 2 to 9, with an average of (6.14±2.79). The VAS score at 3 days after operation was 0-5, with an average of (2.02±1.52) points, and the difference was statistically significant compared with that before operation (P <0.05).The VAS score at 12 months after surgery was 0 to 3, with an average of (1.09±0.92) points, which was significantly improved compared with 3 days after surgery, and the difference was statistically significant (P<0.05). VAS scores of patients before lower extremity pain ranged from 4 to 9 points, with an average of (6.58±2.20) points. The VAS score at 3 days after surgery was 0-5, with an average of (1.72±1.45) points, and the difference was statistically significant compared with that before surgery (P<0.05). The VAS score at 12 months after surgery was 0~3, with an average of (1.13±0.95), and the difference was statistically significant compared with 3 days after surgery (P<0.05).ODI score of patients decreased from (77.25±9.82)% before surgery to (15.73±9.86)% after 12 months of follow-up, with statistical significance (P<0.05).Postoperative complications included cerebrospinal fluid leakage in 3 cases, radiculopathy in 2 cases, incomplete reduction in 1 case, and open surgical revision of internal fixation rupture in 1 case. According to Macnab criteria, 27 patients were excellent (58.7%), 15 were good (32.6%), and 4 were average (8.7%), with no adverse evaluation.Conclusion The results of this study indicate that PE-PLIF is a safe and effective treatment for mild lumbar spondylolisthesis.

Key words: lumbar degeneration; minimally invasive surgery; posterior approach; lumbar fusion