Quadrant减压sextant内固定治疗退变性腰椎失稳症与开放TILF临床对比分析  

Comparative study on Quadrant decompression combined with sextant fixation and open TILF in the treatment of degenerative lumbar instability

作　　者：刘家瑞[1] 朱肖奇[1] 程小芸[1] 叶彩霞[1] 麦爱贞[1] 

机构地区：[1]南方医科大学附属深圳宝安医院,广东深圳518000

出　　处：《实用临床医药杂志》2012年第13期37-40,共4页Journal of Clinical Medicine in Practice

摘　　要：目的比较Quadrant系统下TLIF与传统开放手术治疗腰椎退变性失稳临床疗效。方法随机取本院2006年10月~2012年4月腰椎滑脱症患者60例,随机分为两组：微创组（Quadrant系统下手术）与开放组,于围术期分别记录两组患者的手术时间、术中出血量、术后引流量及输血量;术后3个月、半年采用Oswestry功能障碍指数（ODI）进行疗效评估,计算改善率,并于椎间融合后4~6个月进行疗效评定。结果微创组的手术时间、术中出血量、术后引流量及术后输血量均明显少于开放组,两组差异有统计学意义（P〈0.05或P〈0.01）。两组术后3个月改善率差异无统计学意义（P〉0.05）,术后1年改善率差异有统计学意义（P〈0.05）。术后微创组疗效显著优于开放组（P〈0.05）。结论 Quadrant通道下减压sextant内固定治疗退变性腰椎失稳症疗效优于传统开放手术,是临床上可供选择的一种微创新术式。Objective To compare the clinical efficacy of Quadrant decompression combined with sextant fixation and open TILF in the treatment of degenerative lumbar instability.Methods Sixty patients of degenerative lumbar instability patients were randomly selected from October 2006 to April 2012 and divided into minimally invasive group（operated under Quadrant system） and open group.The operation duration,the amount of intraoperative blood loss,the amount of postoperative drainage and the amount of postoperative transfusions in the two groups were recorded respectively during the perioperative period.Three months and 6 months after operation,Oswestry dysfunction index（ODI） was employed to assess the treatment efficacy,and calculate the improvement rate.Four to 6 months after lumbar fusion,efficacy was evaluated.Results The operation duration,the amount of perioperative blood loss,the amount of postoperative drainage and the amount of postoperative blood transfusion were significantly less in the minimally invasive group than in the open group.The differences of the two groups were statistically significant（P0.05）,but difference was statistically significant one year after treatment（P〈0.05）.The curative efficacy of the minimally invasive group was significantly better than that of the open group（P〈0.05）.Conclusion The efficacy of Quadrant decompression combined with sextant fixation for degenerative lumbar instability is better than that of open TILF.It is a good clinical choice for degeneratie lumbar instability disease.

关 键 词：QUADRANT系统 sextant内固定 TILF退变性腰椎失稳症 经关节突椎间融合术 脊柱微创手术 

分 类 号：R687.3[医药卫生—骨科学]