微创Quadrant系统在腰椎退变疾病手术中的应用  

The application of Quadrant system in Surgical treatment of lumbar degeneration diseases

作　　者：何向阳[1] 李平生[1] 林国叶[1] 王猛[1] 黄玉栋[1] 

机构地区：[1]南京军区福州总医院附属第一医院骨科,福建莆田351100

出　　处：《颈腰痛杂志》2013年第1期22-25,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨微创Quadrant系统下经多裂肌间隙入路椎弓根螺钉固定,椎间植骨融合(TLIF)治疗腰椎退行性疾病的近期疗效及安全性。方法 2010-01-2012-03,72例腰椎退行性疾病患者接受了单节段TLIF手术,采用微创Quadrant系统下手术33例(微创组),传统开放手术39例(开放组),对两组切口长度、手术时间、术中出血量、近期临床疗效、并发症等进行比较。结果所有患者均获随访,随访时间12～18月,平均15月。两组手术时间无明显统计学差异(P>0.05),微创组术中出血量、伤口引流量、住院天数、术后应用镇痛药剂量均明显低于开放组(P<0.01),微创组术后疼痛评分(VSA评分)及ODI功能指数较开放组明显降低(P<0.01),两组患者均未出现神经损伤并发症。结论微创Quadrant系统下TLIF手术治疗腰椎退变具有创伤小、出血少、恢复快、住院时间短、近期疗效好等优点。Objective To evaluate the clinical effect of minimally invasive transmu[tifidus ap- proach by the Quadrant system for lumbar degenerative disease. Methods From Jan 2010 to Mar 2012,72 patients with lumbar degenerative diseases were divided into two groups and underwent different types of transforaminal lumbar interbody fusion surgery. Mininmally invasive TLIF （MIS-TLIF）group （33 cases）received minimally invasive treatment with DePuy Viper 1 system com- bined endoscopically assisted TLIF. Open TLIF group （39 cases） underwent traditional open TLIF surgery. The length of the cut,the blood loss,operation time and effect were observed and compared between the two groups. Results All cases had been followed up between 12-18 months,average of 15 months. There was no significant differences in operation time between the groups（P〉0.05）. Sur- gical blood loss,surgical draining loss,hospital stay,analgesics use and dose （P〈0.01） were less in MIS-TLIFgroup. The scores of VAS and ODI in MIS-TLIDF group were less than those in Open TLIF group（P〈0.01 ）. Conclusion The application of Quadrant system in Surgical treatment of lumbar degeneration,which has less injury,less blood loss,less hospital stay,and satisfied function recovery,is an effctive minimally invasive surgical method.

关 键 词：腰椎退行性疾病 多裂肌间隙 微创 经椎间孔腰椎椎体间融合术 

分 类 号：R681.55[医药卫生—骨科学]