直视下微创与切开进行单节段经椎间孔腰椎融合术的临床效果比较  

Clinical outcomes comparison of minimally invasive versus open single-level transforaminal lumbar interbody fusion under straight view

作　　者：毛克亚[1] 王岩[1] 肖嵩华[1] 张永刚[1] 刘保卫[1] 张西峰[1] 崔庚[1] 张雪松[1] 程自申[1] 李鹏[1] 

机构地区：[1]解放军总医院骨科,北京复兴路28号100853

出　　处：《中国矫形外科杂志》2012年第9期769-773,共5页Orthopedic Journal of China

基　　金：国家自然科学基金(编号:39670731);国家863计划(编号:2009AA02Z405)

摘　　要：[目的]观察直视下微创(minimally invasive,MIS)采用普通椎弓根螺钉完成单节段经椎间孔腰椎融合(transforaminal lumbar interbody fusion,TLIF)的临床结果。[方法]2007～2009年期间26例患者直视下进行单节段腰椎MIS-TLIF手术,45例患者采用Open-TLIF进行单节段腰椎手术,均采用普通椎弓根螺钉内固定,比较两组临床效果。[结果]MIS组术中出血量、术后引流量、下地活动时间和平均住院日均明显低于Open组,术后5 d MIS组腰痛VAS评分优于Open组,而两组腿痛VAS、ODI评分和融合率无显著差异。[结论]直视下MIS与Open两组同样具有长期优良的临床治疗结果,但是MIS组的手术出血量、术后引流量、下地活动时间、术后住院时间和术后短期腰痛均优于Open组。[ Objective] To observe clinical outcomes of minimally invasive （MIS） single -level transforaminal lumbar in- terbody fusion （TLIF） under straight view using common pedical screw. [ Methods] From 2007 -2009, 26 patients were trea- ted with single - level MIS TLIF under straight view and 45 patients were treated with single - level open TLIF using common pedicle screw. The clinical results of two groups were compared. [ Resnits ] There were less operative, postoperative blood loss, ambulation time and hospitalization time in MIS groupthan in open group. The back pain VAS score of MIS group in postop- erative 5 days were better than in open group, but the difference couldnt be found in postoperative leg pain VAS, ODI scores and lumbar fusion of two groups. [ Conclusion] MIS and open groups had similar good long - term clinical outcomes, but the oper- ative blood loss, postoperative blood loss, ambulation, postoperative hospital time and postoperative short term back pain in MIS group are better than in open group.

关 键 词：经椎间孔腰椎融合术 微创手术 切开手术 临床结果 

分 类 号：R687.3[医药卫生—骨科学]