IsoC-3D计算机导航结合MastQuadrant通道管微创治疗腰椎退行性疾病  

Minimally invasive surgical treatment for lumbar degenerative disease with IsoC-3D navigation under Mast Quadrant system

作　　者：关宏刚[1] 王刚[1] 霍智铭[1] 沈源彬[1] 陈超[1] 梁亮科[1] 

机构地区：[1]佛山市中医院骨科,广东佛山528000

出　　处：《中国骨伤》2012年第6期451-454,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨IsoC-3D计算机导航下结合MastQuadrant通道管微创减压、椎间融合、经皮椎弓根钉内固定治疗腰椎退行性病的疗效。方法:2009年1月至2010年2月,采用IsoC-3D计算机导航下经皮椎弓根内内固定结合MastQuadrant通道管下椎管减压、椎间融合术治疗腰椎退行性疾病患者21例,男12例,女9例;年龄36～72岁,平均50.2岁。临床疗效采用Oswestry功能障碍指数(Oswestrydisabilityindex,ODI)评分、疼痛视觉模拟评分(Visualana-logscale,VAS)及患者满意度进行评定。结果:18例(85.7%)患者得到随访,随访时间6～18个月,平均10个月。无手术相关的并发症。ODI评分术前(49.6±12.2)分,末次随访时为(17.2±9.2)分,与术前比较明显下降(P<0.01)。腿痛VAS评分术前(75.2±10.0)分,末次随访时下降至(12.2±11.8)分(P<0.01)。腰痛VAS评分从术前(59.9±17.3)分下降至末次随访时(16.6±11.5)分(P<0.01)。16例患者对手术效果感到满意。结论:作为一种新型微创术式,MastQuadrant通道管在显微镜及目视下进行椎管减压、椎间融合,同时结合三维导航系统技术快速辅助下行经皮椎弓根钉内固定,临床疗效良好,具有组织损伤轻、出血少、住院时间短的优点。Objective：To evaluate the effects of surgical treatment of IsoC-3D navigation assisted percutaneous pedicle screw fixation, vertebral canal decompression and interbody fusion using Mast Quadrant system in patients with lumbar degen- erative disease. Methods：From January 2009 to February 2010,21 patients with lumbar degenerative disease were treated with IsoC-3D navigation under Mast Quadrant system. There were 12 males and 9 females,with an average age of 50.2 years （ranged, 36 to 72 years）. All patients underwent discectomy,vertebral canal decompression,cage implantation using Mast Quadrant system and IsoC-3D navigation assisted sextant lumbar fixation. Clinical outcomes were evaluated with Oswestry dis- ability index （ODI）, Visual analog scale （VAS） and degree of satisfaction of patients. Results：Eighteen patients （85.7%） were followed up from 6 to 18 months with an average of 10 months. No surgery-related complications were found. The preoperative, postoperative ODI scores was 49.6±12.2 and 17.2±9.2, respectively （P〈0.01） ;VAS score of leg pain decreased from preopera- tive 75.2±10.0 to 12.2±11.8 at final follow-up （P〈0.01） ;VAS score of lumbago decreased from preoperative 59.9±17.3 to 16.6±11.5 at final follow-up （P〈0.01）. Sixteen patients obtained satisfactory results. Conclusion： IsoC-3D navigation assisted percutaneous pedicle screw fixation,vertebral canal decompression and interbody fusion using Mast Quadrant system could achieve satisfactory clinical results in treating lumbar degenerative disease and may be a better alternative to conventional sur- gical procedures. It has advantages such as limited tissue damage, less blood loss, short time in hospital.

关 键 词：退行性疾病 腰椎 外科手术 计算机辅助 脊柱融合术 减压 

分 类 号：R681.57[医药卫生—骨科学]