Comparison The Clinical Effect Of Cortical Bone Trajectory-Midline Lumbar Interbody Fusion And Transforaminal-Posterior Lumbar Interbody Fusionin In The Treatment Of Degenerative Lumbar Spinal Disease

Objective: To compare the clinical effect and imaging results of Cortical Bone Trajectory-Midline Lumbar Interbody Fusion and Transforaminal-Posterior Lumbar Interbody Fusion in the treatment of Degenerative Lumbar Spinal Disease.Methods: 75 patients with DLSD who underwent surgical treatment in our hospital's orthopedics department were taken as the research subjects from January 2017 to May 2018.They were divided into MIDLIF group:(34 cases),T-PLIF group:(41 cases)according to the different operation methods.The intraoperative blood loss,postoperative drainage volume,operation time,postoperative hospital stay and complications of patients in two groups were compared.Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)scores were calculated during treatment period.The lumbar lordosis(LL),segmental lumbar lordosis(SLL),disc height(DH),and fusion rate were measured and recorded.Results: There were no significant differences in sex,age,operative segment composition,BMI value,operation time and postoperative hospital stay between the two groups(P>0.05),The differences in the intraoperative blood loss and postoperative drainage volume between the two groups were statistically significant(P<0.05).The intraoperative blood loss and postoperative drainage volume in MIDLIF group were significantly lower than those in T-PLIF group.The results of VAS and ODI scores showed that the differences inpreoperative and postoperative ODI and VAS between the two groups were statistically significant(P<0.05).The average scores of 1 month and 6 months after operation in MIDLIF group were lower than that in T-PLIF group,the differences were statistically significant(P <0.05);There were no significant differences in the average scores between the two groups at12 months and 24 months after operation(P >0.05).The radiological results showed that there were significant differences in lumbar lordosis,segmental lumbar lordosis and disc height between pre-and post-operation in T-PLIF group(P<0.05).There was no significant difference in postoperative lumbar lordosis in MIDLIF group compared with preoperative(P>0.05).There were no significant differences in fusion rates between the two groups after opration(P>0.05).The complications between the two groups had no significant difference(P>0.05).Conclusion : Both T-PLIF and MIDLIF can achieve satisfactory clinical effict and fusion rates in the treatment of Degenerative Lumbar Spinal Disease.T-PLIF has more advantages in improving lumbar lordosis,MIDLIF can reduce blood loss,postoperative drainage and relieve perioperative pain.The long-term effects of the two operations need further observation and study.