经椎间孔腰椎间融合术在高位腰椎间盘突出症手术治疗中的应用  

Transforminal lumbar interbody fusion technique in treatment of upper lumbar intervertebral disc herniation

作　　者：马东印[1] 周自广[1] 范江涛[1] 刘爱华[1] 范久庆 王兴龙[1] 

机构地区：[1]北京市平谷区医院骨科,101200

出　　处：《中国矫形外科杂志》2009年第17期1300-1302,共3页Orthopedic Journal of China

摘　　要：[目的]探讨经椎间孔腰椎间融合术（transforminal lumbar interbody fusion，TLIF）治疗高位腰椎间盘突出症的手术疗效。[方法]2002年1月-2006年12月采用TLIF技术治疗且获得12—24个月（平均15个月）随访的高位腰椎间盘突出症患者45例。男29例，女16例；年龄30～55岁，平均39．2岁。T12L1突出11个间隙，L1、2突出25个间隙，L2、3突出18个间隙，其中双间隙突出9例。所有患者均采用经椎间孔椎间盘切除、钛网植入、植骨融合＋后路钉棒系统内固定术。对手术疗效进行回顾性分析。[结果]出现并发症5例次，经对症处理后好转。术后2～3d配戴腰围下床活动。平均随访15个月，Oswestry评分从术前（52．32±9．17）分改善至（20．33±5．72）分。并获得较好的植骨融合，相邻节段无明显退变。[结论]TLIF技术是治疗高位腰椎间盘突出症的有效方法，并可获得较满意的临床疗效。[ Objective ] To investigate the surgical method of transforminal lumbar interbody fusion （TLIF） technique in treatment of upper lumbar intervertebral disc herniation. [ Methods] From January 2002 to December 2006, a retrospective analysis on TLIF surgery treatment of 45 patients with upper lumbar intervertebral disc herniation were carried out and they acquired 12 -24 months （mean, 15 months） follow up. There were 29 males, and 16 females aging from 30 - 55 years （mean, 39. 2 years） . Eleven intervertebral spaces were T12 -L1 hernination, 25 intervertebral spaces were L1,2 bernination, and 18 intervertebral spaces were L2,3 hernination of the space. Nine were double disc herniation. All cases were treated with TLIF technique. A retrospective analysis on surgical therapeutic effect was made. [ Results] Five patients developed complications after operation and recovered by symptomatic treatment. Patients moved around in 2 - 3 d after surgery. Oswestry score improved from （ 52. 32 ± 9.17 ） to （20. 33 ± 5.72） in an average 15 - months follow - up. X - ray showed that all cases had bone graft fusion and no adjacent segment degeneration occurred. [ Conclusion ] TLIF technique is an effective method in treatment of upper lumbar intervertebral disc herniation. It can offer satisfactory clinical effects.

关 键 词：高位腰椎间盘突出症 经椎间孔腰椎间融合术 手术治疗 

分 类 号：R687.3[医药卫生—骨科学]