Quadrant通道下治疗退变性腰椎滑脱的临床疗效  

Clinical research of mast quadrant retractor in the management of degenerative lumbar spondylolisthesis

作　　者：滕海军[1] 王亮[1] 郭志良[1] 范丽静[1] 张大海[1] 刘超[1] 

机构地区：[1]解放军第89医院脊柱外科,山东潍坊261021

出　　处：《临床骨科杂志》2012年第5期498-500,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨采用Quadrant通道下微创治疗退变性腰椎滑脱的近期临床效果。方法采用Quadrant通道下植骨融合内固定治疗22例退变性腰椎滑脱。滑脱部位:L4～514例,L5～S18例。术前腰痛视觉模拟评分(VAS)为6.2分±3.1分。结果手术时间92～178 min,术中出血量221～419 ml,住院时间为7～16 d。术后7 d切口均一期愈合。术后即刻X线片示滑脱椎体均复位。患者均获随访,时间12～36个月。均已达到骨性融合。末次随访时VAS为1.4分±2.2分,与术前比较差异有统计学意义(P<0.05)。末次随访时按Nakai评定标准:优18例,良4例。X线片检查未见椎弓根螺钉内固定系统的松动、断裂或移位。结论在严格掌握手术适应证的情况下,采用Quadrant可扩张通道下技术治疗退变性腰椎滑脱近期疗效确定,是一种安全、有效的微创方法。Objective To evaluate the effect of posterior lumbar interbody fusion （PLIF） using mast quadrant retrac- tor in the management of degenerative lumbar spondylolisthesis. Methods 22 cases of lumbar spondylolisthesis suffered with low back pain or/and mono leg pain were reviewed retrospectively. Of the total vertebraes, 14 cases were L4_5, 8 cases were L5 - S1. VAS score was used at pre-operation and final follow-up. VAS score was （6.2 ±3. 1 ） at pre-operation. Results The average operating time was 92 ±178 min and the average amount of blood loss was 221 - 419 ml. The average hospital stay time was 7 - 16 d. The incisions got heading in 7 d. Postoperative X-ray showed slipped vertebra reduction. The mean follow-up duration was approximately from 12 to 36 months. The VAS of low back pain decreased from （6. 2 ±3. 1 ） preoperation to（ 1.4 ±2. 2） the last following up after operation（P 〈0. 05）. Lumbar interbody fusion was achieved in all the patients according to X-ray Coe et al criteria. According to Nakai standard, the results were excellent in 18 cases , good in 4 at the last following up . The radiological evaluations showed no failure of the internal fixation. Conclusions As long as the indication is criticized chosen , PLIF via mast quadrant retractor is a safe and effective minimally invasive surgical technique in treating degenerative lumbar spon- dylolisthesis.

关 键 词：Quadrant可扩张通道 腰椎后路椎间融合术 退变性腰椎滑脱 外科手术 微创性 

分 类 号：R681.57[医药卫生—骨科学] R687.3[医药卫生—外科学]