METR_X内窥镜辅助X-Tube下减压、融合、内固定治疗腰椎退变性疾病  

Treatment of lumbar degenerative diseases with pedicle screw fixation,decompression and interbody fusion under METR_X endoscopic (X-Tube) system

作　　者：陈远武[1] 易伟宏[1] 刘春利[1] 张德仁[1] 王锡三[1] 胡广询[1] 王尔天[1] 王敏[1] 黄曹[1] 刘赫[1] 罗万荣[1] 

机构地区：[1]广东医学院附属南山医院骨二科,广东深圳518052

出　　处：《临床骨科杂志》2009年第3期254-256,共3页Journal of Clinical Orthopaedics

基　　金：深圳市科技基金资助项目(编号:200803175)

摘　　要：目的探讨METRX内窥镜辅助X-Tube下腰椎管减压、椎间盘切除、椎间植骨融合、椎弓根螺钉内固定治疗腰椎退变性疾病的临床效果。方法对11例腰椎间盘突出和(或)腰椎滑脱患者应用METRX内窥镜手术系统辅助下行椎管减压、椎间盘切除、椎间植骨融合、椎弓根螺钉内固定治疗。结果1例出现疼痛、麻木症状加重,1例术中出现脑脊液漏,给予对症处理均治愈。手术切口均一期愈合。所有患者均获随访,时间3～27个月。ODI评分:术前为(49±17)分,术后3个月为(38±19)分,末次随访为(15±13)分;VAS评分:术前为(7.2±1.0)分,术后3个月为(5.1±1.1)分,末次随访为(1.5±1.1)分;与术前比较差异均有显著性(P<0.05)。末次随访时采用改良Macnab标准评价临床效果:优6例,良4例,可1例。结论内窥镜辅助X-Tube下腰椎管减压、椎间融合、椎弓根螺钉固定治疗腰椎退变性疾病可获得良好的临床效果,是一种安全有效的微创手术方法。Objective To explore the outcome of METRx endoscopic （X-Tube） system used in decompression, discectomy and intervertebral fusion by bone autograft. Methods 11 cases of lumbar disc herniation and spondylolisthesis were given decompression, disceetomy, intervertebral bone graft, and pedicle screw fixation under METRx endos- copy. Results 1 patient got worse in pain and numbness. 1 case got cerebrospinal fluid leakage during operation. All wound healed in one stage. All patients were followed up for 3 to 27 months, with an average of 17 months. ODI were 49 ± 17,38 ± 19 and 15 ± 13, and VAS were 7.2 ± 1.0,5.1 ±1.1 and 1.5 ± 1.1 before operation, three months postoperatively, and last follow-up after operation, respectively. There were significant difference of ODI and VAS between before and after operation （ P 〈 0. 05 ）. The results were excellent results in 6 cases, good in 4, fair in 1 elevated by Maenab scale at the last follow-up. Conclusions Lumbar decompression, interbody fusion and pedicle screw fixation under endoscopy（ METRx ） system an achieve satisfactory clinical results in treating lumbar degenerative disease, which is a safe and effective minimally invasive surgical method.

关 键 词：内窥镜检查(METRX) 腰椎间盘突出症 腰椎管狭窄症 腰椎滑脱症 后路腰椎间融合 椎弓根螺钉固定 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]