小切口椎旁肌间隙入路腰椎后路融合术的临床研究  

Clinical study of minimally invasive Witlse approach for lumbar posterior intervertebral fusion

作　　者：陈宣煌[1] 许卫红[2] 胡建伟[2] 陈荣生[2] 李贵双[2] 张怀志[1] 郑祖高[1] 

机构地区：[1]莆田学院附属医院骨科,福建莆田351100 [2]福建医科大学附属第一医院脊柱外科,福建福州35005

出　　处：《实用临床医药杂志》2011年第24期24-26,30,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨采用小切口椎旁肌间隙入路行腰椎后路融合术的手术方法、技巧和临床疗效。方法收集采用小切口椎旁肌间隙入路行下腰椎后路融合术的患者60例，观察临床疗效及腰椎磁共振所示的多裂肌萎缩和脂肪沉积情况。结果随访6～18月，平均12．2月，按Nakai疗效评定标准评定：优42例，良16例，可2例，差0例，优良率96．7％。术前、术后多裂肌面积无明显萎缩，脂肪沉积少。结论小切口椎旁肌间隙入路操作学习曲线短，可减少对多裂肌的损伤，有利于患者术后的恢复。椎旁肌间隙人路配合微型拉钩等简单手术器械相对于微创扩张管道更容易推广。Objective To study the surgical methods, techniques and clinical efficacy in the PLIF technique by minimally invasive Wiltse approach. Methods According to inclusion and exclu- sion criteria, the data of 60 patients who was applied with Wihse approach was reviewed. Clinical effi- cacy and fat degeneration grades of multifidus muscle shown by MRI were observed. Results A follow - up was carried out for 6 to 18 months. According to the Nakai classification, excellent results were achieved in 42 patients, good in 16 patients, fair in 2 and poor in 0, The rate of excellent and good outcomes was 96.7%. No statistical difference was found in the cross sectional area and the fat degen- eration grades of multifidus muscle between preoperative results and that of the follow - up MRI. Con- clusion Wihse approach learning curve is short. It causes less paraspinal muscle damage and has positive effects on treating back pain. A simple micro - hooks and other minimally invasive surgical in- struments relative to the expansion chamber is easier to replicate.

关 键 词：椎旁肌间隙入路 多裂肌 小切口 临床疗效 

分 类 号：R681.57[医药卫生—骨科学]