多裂肌间隙入路微创经椎间孔腰椎椎体间融合术治疗腰椎退变性疾病  

Treatment of lumbar degenerative disease with minimally invasive transforaminal lumbar interbody fusion through transmultifidus approach

作　　者：俞新胜[1] 肖波[1] 杨淮河[1] 汪普[1] 李勇宏[1] 张军[1] 林立波[1] 

机构地区：[1]解放军第94医院骨科,江西南昌330002

出　　处：《生物骨科材料与临床研究》2013年第5期35-38,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨多裂肌间隙入路微创经椎间孔腰椎椎体间融合术治疗腰椎退变性疾病的临床效果。方法回顾性分析我院2009年2月～2012年2月收治的32例单节段腰椎退变性疾病患者，采用多裂肌间隙入路进行微创经椎间孔腰椎体间融合手术，椎间斜行置入单枚椎间融合器，双侧椎弓根螺钉固定，观察围手术期指标、融合率，并对手术前后疗效进行比较。结果随访时间12-23个月，平均14．5个月。平均手术时间（156．3±36．4）分钟，平均术中出血量（186．2±82．5）ml，平均术后引流量（101．8±43．6）ml，平均下地时间（4．2±1．4）天，平均住院天数（9．3±2．2）天。并发症：2例暂时性神经根损伤，1例硬膜囊撕裂。融合情况：融合14例（43．8％），可能融合18例（56．2％），无非融合病例。腰痛、腿痛VAS评分及ODI评分术后随访较术前均明显改善，差异有统计学意义（P〈O．05）。结论多裂肌间隙入路微创经椎间孔腰椎椎体间融合术对腰椎退变性疾病可获得可靠的融合和满意的临床效果。Objective To investigate the clinical outcomes of the minimally invasive transforaminal lumbar interbody fusion through transmultifidus approach in lumbar degemerative diseases. Methods A retrospective analysis was per formed on 32 patients who underwent the minimally invasive transforaminal lumbar interbody fusion through transmulti fidus approach using bilateral pedical screws and a diagonal cage in our hospital fi＇om February 2009 to February 2012. The results of perioperative parameters, fusion rates and clinical outcomes were recorded and the clinical outcomes were compared among postoperative and preoperative procedure. Results Mean follow-up duration was 14.Smonths. The av erage operation time （156.3±36.4） min, the average intra-operative blood loss （186.2±82.5） ml, the average postoperative drainage （101.8±43.6） ml, the average postoperative ambulation time （4.2±1.4） d, and the average postoperative stay （9.3±2.2） d. Operative complications included neurological injury in 2 case, dura tearing in 1 cases. No cases of nonunion was found in patients. During the follow-up, the postoperative visual analogue scales and Oswestry disability index scorces were significance improved with preoperative scorces （P 〈 0.05）. Conclusion Treatment of lumbar degenerative diseases with the minimally invasive transforaminal lumbar interbody fusion through transmultifidus approach can get sat- isfactory fusion rates and clinical outcomes.

关 键 词：腰椎 微创 经椎间孔腰椎椎体间融合术 退变性疾病 多裂肌间隙入路 

分 类 号：R687.3[医药卫生—骨科学]