Quadrant系统联合Sextant-R系统微创治疗腰椎滑脱症的临床研究  

Clinical research of minimally invasive surgical management for lumbar spondylolisthesis via quadrant system assisted Sextant-R system.

作　　者：康辉[1] 蔡贤华[1] 徐峰[1] 黄勇[1] 

机构地区：[1]广州军区武汉总医院骨科,湖北武汉430070

出　　处：《颈腰痛杂志》2013年第3期217-220,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨Quadrant系统联合Sextant-R系统微创治疗腰椎滑脱症的临床疗效。方法本组共收治腰椎滑脱症32例,其中峡部裂型13例、退变性19例。均采用椎旁肌间隙入路Quadrant系统下减压、植骨、融合,Sextant-R系统下进行置钉、滑脱提拉复位。采用VAS疼痛评分评估术前、术后一年的疼痛情况;采用腰椎JOA功能评分对术前、术后一年的腰椎功能进行评估、并计算改善率。通过滑脱率、滑脱角、椎间高度评估滑脱矫正情况。结果所有患者术中均无脑脊液漏、无神经根损伤。随访时间20～45个月,平均28个月。所有患者植骨均融合,无椎弓根螺钉断裂,融合器移位。VAS评分和JOA评分术前与术后一年比较有统计学差异(P<0.05)。滑脱率由术前恢复到术后一年;滑脱角由术前恢复到术后一年;椎间高度由术前恢复到术后。结论把握好适应证,Quadrant系统联合Sextant-R系统微创治疗腰椎滑脱症是安全、有效的。Objective To analyze the effectiveness of minimally invasive surgical management for lumbar spondylolisthesis via quadrant system assisted Sextant-R system. Methods The clinic data of 32 patients with lumbar spondylolisthesis were reviewed and analyzed,included isthmic spondylolisthesis（n=13） and degenerative spondylolisthesis（n=19）. The surgeries performed minimally invasive via quadrant system by bilateral muscle gap for decompression and fusion,via Sextant-R system for fixation.and reduction. VAS score system was used to evaluate back pain the pre-and post operative （12 months）. JOA score system was used to evaluate the pre-and post operative （12 months） score and improvement rate. The radiographic data was evaluated, included slipping degree,slipping angle and intervertebral disc height. Results There were no leakage of cerebrospinal fluid and nerve root injury during the operation. All patients were followed up for 20-45 months （mean,28 months）. The VAS and JOA score showed statistical significance （P〈0.05） between preoperative and 12 months postoperation. The slipping degree significantly decreased from preoperative to at 12 months posloperatively. Slip angle form preoperative to at 12 months posloperatively. Intervertebral disc height form preoperative to at 12 months Posloperat ively. Condusion Minimally invasive surgical management for lumbar spondylolisth-esis via quadrant system assisted Sextant-R system is effective. However,its indications should be well considered.

关 键 词：腰椎 微创 滑脱 QUADRANT系统 Sextant-R系统 

分 类 号：R681.55[医药卫生—骨科学]