双侧小切口肌间隙入路腰椎椎体间融合治疗下腰椎退行性疾病  

Using small incision of dual side and paraspinal approach lumbar interbody fusion for the treatment of lumbar degenerative disease

作　　者：方志祥[1] 李坚[1] 闫亮[1] 许海波[1] 赵建峰[1] 

机构地区：[1]绍兴第二医院骨科一病区,浙江绍兴312000

出　　处：《临床骨科杂志》2012年第6期630-632,共3页Journal of Clinical Orthopaedics

摘　　要：目的评价双侧小切口肌间隙入路腰椎椎体间融合治疗下腰椎退行性疾病的疗效。方法采用双侧小切口肌间隙入路腰椎椎体间融合结合椎弓根螺钉内固定治疗32例下腰椎退行性疾病患者,观察手术时间、术中出血量及术后症状缓解情况。术前、术后采用视觉模拟疼痛评分(VAS)评价疗效。结果手术时间90～150(110±21)min,术中出血量150～380(282±37)ml。患者伤口均一期愈合。32例均获随防,时间7～14个月。术后2周及末次随访VAS评分,与术前比较差异均有统计学意义(P<0.05)。末次随访椎体间均骨性融合,融合率为100%。未发生螺钉松动、断钉等情况。结论双侧小切口肌间隙入路腰椎椎体间融合治疗下腰椎退行性疾病,切口小、术中出血少、软组织损伤小、术后恢复快,疗效满意。Objective To study the clinical results of lumbar interbody fusion through small incision of dual side and paraspinal approach in the treatment of lumbar degenerative disease. Methods 32 patients who had lumbar degener- ative disease underwent single level decompression and lumbar interbody fusion through small incision of dual side pa- raspinal approach. The operative time, operative blood loss and improvement of clinical symptoms were assessed, vis- ual analogue scores （VAS） was used to evaluate the effect of the operation. Results Operation time was 90 ～ 150 （ 110 ± 21 ） rain, blood loss in the operation was 150 ～380 （282 ± 37 ） ml. Incisions were primary healed. All patients were followed up for 7 ～ 14 months, the VAS score of two weeks after the operation and the last followed up had statis- tically significant difference from the scores of the preoperation （ P 〈0. 05 ）. All cases had bone union and no screws were loosed or broken in the last followe-up, the rate of bone fusion was 100%. Conclusions The lumbar interbody fusion through the small incision of dual side paraspinal approach is an effective method in the treatment of lumbar de- generative disease, which can reduce the blood loss and injury of the soft tissue, accelerate the rehabilitation simulta- neously.

关 键 词：腰椎退行性疾病 脊柱融合术 旁入路 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]