Quadrant通道下单切口治疗腰椎滑脱近期疗效观察  

RESEARCH OF SINGLE INCISION VIA MAST QUADRANT RETRACTOR IN MANAGEMENT OF LUMBAR SPONDYLOLISTHESIS

作　　者：滕海军[1] 王亮[1] 郭志良[1] 范丽静[1] 张大海[1] 张伟[1] 王时东[1] 

机构地区：[1]解放军第89医院脊柱外科二区,山东潍坊261021

出　　处：《中国修复重建外科杂志》2010年第5期517-520,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨采用Quadrant通道下单切口技术微创治疗腰椎滑脱的方法及疗效。方法2008年7月-2009年6月,采用Quadrant通道下单切口植骨融合内固定治疗20例腰椎滑脱。男8例,女12例;年龄34～62岁,平均45.5岁。病程1～6年,平均34.5个月。滑脱部位:L4、58例,L5、S112例。18例为双侧峡部裂型滑脱,2例为退变型滑脱;根据Meyerding滑脱分级标准评定均为Ⅰ度滑脱。术前患者疼痛视觉模拟(VAS)评分为(6.6±1.2)分。结果患者手术时间(155±23)min,术中出血量(360±102)mL,住院时间为(12.0±3.4)d。术后切口均Ⅰ期愈合。术后即刻X线片示滑脱椎体均复位。患者均获随访,随访时间9～20个月,平均14.3个月。末次随访时VAS评分为(1.6±2.3)分,与术前比较差异有统计学意义(P<0.05)。X线片示术后6个月椎体间达骨性融合,未见椎弓根螺钉内固定系统松动、断裂或移位。末次随访时按Nakai分级评定标准,获优18例,良2例。结论在严格掌握手术适应证的情况下,Quadrant通道下单切口技术是一种治疗腰椎滑脱安全、有效的微创方法。Objective To evaluate the effect of posterior lumbar interbody fusion （PLIF） using single incision via MAST Quadrant retractor in the management of lumbar spondylolisthesis. Methods From July 2008 to June 2009,20 cases of lumbar spondylolisthesis were treated with posterior lumbar interbody fusion via MAST Quadrant retractor using single incision,including 2 cases of degenerative spondylolisthesis and 18 cases of isthmic spondylolisthesis. There were 8 males and 12 females aged from 34 to 62 years （average 45.5 years）. The disease course was 1 to 6 years （mean 34.5 months）. The spondylolisthesis locations were L4,5 in 8 cases and L5,S1 in 12 cases. According to Meyerding classification,all cases were classified as degree I. The Visual Analogue Scale （VAS） score was （6.6 ± 1.2） points. The operative time,the blood loss,and the therapeutic effects were recorded. Results The operative time was （155 ± 23） minutes and the amount of blood loss was （360 ± 102） mL. The hospitalization time were （12.0 ± 3.4） days. All incisions healed by first intention. X-ray films showed spondylolisthesis reduction immediately after operation. All patients were followed up 14.3 months on average （from 9 to 20 months）. The VAS score decreased to （1.6 ± 2.3） points at the last follow-up,showing signifi cant difference when compared with that of preoperation （P〈 0.05）. The X-ray films showed that lumbar interbody fusion was achieved in all the patients. No lossening,breakage,and displacement of pedicle screw fixation was observed. According to Nakai standard,the results were excellent in 18 cases and good in 2 cases at the last follow-up. Conclusion As long as the indication is strictly chosen,PLIF via MAST Quadrant retractor is a safe,effective,and minimally invasive surgical technique in treating lumbar spondylolisthesis.

关 键 词：腰椎滑脱 QUADRANT通道 单切口 腰椎后路椎间融合术 

分 类 号：R687.3[医药卫生—骨科学]