目的 研究微创经椎间孔入路椎体间融合术（minimally invasive surgerytransforaminal lumbar interbody fusion，MIS⁃TLIF）治疗双节段腰椎退行性疾病中远期疗效。方法 选取 2013 年 12 月至 2015 年 12 月在我科诊治的 62 例双节段退行性腰椎管狭窄症患者，根据不同手术治疗方法将患者分为 MIS⁃ TLIF 组 32 例和开放经椎间孔入路椎体间融合（open transforaminal lumbar interbody fusion，O⁃TLIF）组 30 例。对术后 3、6、12、24 个月和末次随访（54 ~ 72 个月）的 Oswestry 功能障碍指数（Oswestrydisability index，ODI）、疼痛视觉模拟评分（visual analogue scale，VAS）、中远期并发症等进行比较。结果 在术后 3、6 个月时，MIS⁃TLIF 组在腰痛 VAS、ODI 评分低于 O⁃TLIF 组；术后 24 个月和末次随访时，两组在腰痛 VAS评分、下肢痛VAS评分、ODI评分差异均无统计学意义；在末次随访时，两组在VAS评分和ODI评分较术 前均明显下降。邻椎病：MIS ⁃TLIF 组 4 例，O ⁃TLIF 组 5 例；椎体间融合率：MIS ⁃TLIF 组 92.2%，O ⁃TLIF 组 88.3%。结论 MIS⁃TLIF 治疗双节段退行性腰椎管狭窄症创伤小、恢复快、中远期疗效满意且并发症发

Objective To study the mid⁃and long⁃term clinical efficacy of minimally invasive transforami⁃ nal lumbar interbody fusion for the treatment of double ⁃ segment lumbar spinal stenosis. Methods Sixty ⁃two patients with double ⁃ segment lumbar spinal stenosis who were treated in our hospital from Dec2013 to Dec2015 were retrospectively analyzed. These patients were divided into two group ，MIS⁃TLIF group（32 patients）and O⁃TLIF group（30 patients）. Oswestry disability index（ODI），visual analog scale（VAS）were compared between the two groups at 3 months，6 months，12 months，24 months after surgery and the latest follow⁃up. Complications and intervertebral fusion rate were also analyzed. Results Compared to O⁃TLIF group，MIS⁃TLIF group showed a significant decrease in lumbar VAS and ODI at 3 months and 6 months after surgery，but the difference was not significant between the two groups at 12 months，24 months and the latest follow⁃up. Both the two groups showed an obvious decrease in VAS and ODI at latest follow up compared to pre⁃operation. Adjacent segment degeneration was observed in 4 and 5 patients in MIS ⁃TLIF and O ⁃TLIF group respectively. The fusion rate in MIS ⁃TLIF was 92.2%，and 88.3% for O⁃TLIF group. Conclusion MIS⁃TLIF treatment fordouble⁃segment lumbar spinal stenosis can obtain excellent medium and long⁃term outcomes，and this methoddose not increase the incidence of medium