IMPROVEMENT OF ODI AND SF-36 QUESTIONNAIRES SCORE AFTER ONE YEAR OF PLIF OR TLIF

ABSTRACT Objective: Determine if patients undergoing PLIF or TLIF surgery achieved improvement in the score of ODI and SF-36 questionnaires one year after surgery. Methods: Retrospective, single-center and non-randomized study. Patients submitted to spinal surgery using the PLIF or TLIF technique were included who completed the ODI and SF-36 questionnaires at least at the preoperative visit, and one year after surgery. Patients were divided into two groups, Group 1 (1 surgery level) and Group 2 (> 1 surgery level) and the ODI and SF-36 scores were compared for improvement. Results: The mean age was 47 years, with 52% of males (13/25) and mean of 5 days of hospital stay. Patients presented a significant improvement of ODI questionnaire (p<0.001) and in all SF-36 domains except in General Health State (p=0.58). In each group, it was observed that patients submitted to more than one level of surgery had greater blood loss and shorter hospital stay; however, the improvement obtained in ODI and SF-36 compared to the one-level surgery group was similar. Conclusions: PLIF and TLIF techniques are effective and lead to improved scores in ODI and SF-36 questionnaires one year after surgery. Patients undergoing two or more levels of instrumentation showed significant and similar improvement in ODI and SF-36. Level of evidence II, Single-Center Retrospective Study.

摘要 研究目的：明确接受后路腰椎椎体间融合术（PLIF, Posterior Lumbar Interbody Fusion）或经椎间孔腰椎椎体间融合术（TLIF, Transforaminal Lumbar Interbody Fusion）的患者，在术后1年时的Oswestry功能障碍指数（ODI, Oswestry Disability Index）与简明健康调查问卷（SF-36, Short Form 36 Health Survey Questionnaire）评分是否获得改善。
研究方法：本研究为回顾性、单中心非随机研究。纳入接受PLIF或TLIF脊柱手术，且至少在术前访视及术后1年时完成ODI与SF-36问卷测评的患者。将患者分为两组：1组（单节段手术组）与2组（手术节段＞1的多节段手术组），对比两组的ODI与SF-36评分改善情况。
研究结果：本研究纳入患者的平均年龄为47岁，男性占比52%（13/25），平均住院时长为5天。患者的ODI评分及SF-36除一般健康状态外的所有维度评分均得到显著改善（P<0.001），而一般健康状态维度无显著改善（P=0.58）。亚组分析显示，多节段手术患者失血量更多、住院时长更短；但相较于单节段手术组，多节段手术组患者的ODI与SF-36评分改善幅度并无显著差异。
研究结论：PLIF与TLIF手术均具有临床有效性，可使患者在术后1年时的ODI与SF-36评分得到显著改善。接受2节段及以上脊柱融合手术的患者，其ODI与SF-36评分同样得到显著且与单节段手术组相当的改善。本研究证据级别为Ⅱ级，属于单中心回顾性研究。