Wiltse入路MIS-TLIF治疗腰椎退变疾病早期临床疗效研究  

Early Clinical Effect of Minimally Invasive Wiltse Admission Passage MIS-TLIF in Treatment of Lumbar Vertebra Degenerative Disease

作　　者：赵龙[1] 宋有鑫[1] 杨佳宁[1] 祝乃强 崔成喜 张宇轩[1] 尚瑞松 张宝琦[1] 龚平[1] 武云鹤[1] 陈宾[1] 

机构地区：[1]承德医学院附属医院骨科,河北承德067000

出　　处：《实用骨科杂志》2015年第3期193-197,共5页Journal of Practical Orthopaedics

摘　　要：目的本研究旨在探讨微创Wiltse入路经椎间孔椎间植骨融合术（minimally invasive surgery-transforaminal lumbar interbody fusion,MIS-TLIF）治疗腰椎退行性疾病的近期疗效及安全性。方法回顾性分析我院2012年7月至2014年1月收治的腰椎退行性疾病患者63例,随机分为微创组和开放组,术后比较两组患者的手术时间、术中出血量、术后引流量、下地时间、住院时间及患者术前、术后疼痛视觉模拟量表评分（visual analogue scale,VAS）、腰背痛日本骨科协会评分（Japanese orthopaedic association,JOA）。结果微创Wiltse入路MIS-TLIF手术时间、术中出血量、术后引流量、切口长度、下地时间、住院时间及术后3 d VAS评分及JOA评分均明显优于开放TLIF手术。随访3~6个月,术后3个月VAS评分及JOA评分差异无统计学意义。两组均无椎弓根钉断裂、松动、拔出、植骨移位等严重并发症发生。结论 Wiltse入路MIS-TLIF术式具有手术创伤小、时间短、出血少、恢复快、并发症少等优点。通过对早期疗效的研究,该术式在治疗腰椎退行性疾病上可获得与传统开放手术相同的疗效,是一种安全有效的手术方式。Objective To discuss the short-term effects of minimally invasive Wiltse admission psssage MIS-TLIF in treatment of lumbar vertebra degenerative disease. Methods From July 2012 to January 2014,63 cases of patients with lumbar vertebra degenerative diseases received by our hospital from July 2012 to January 2014 were analyzed and divided into two groups,the minimally invasive group and open group. After the surgery,the time of operation,bleeding volume in operation,post-operative drainage volume,walking time,hospitalization time,visual analogue scale（ VAS） before and after the surgery,as well as the lumbago and backache of Japanese Orthopaedic Association（ JOA） were compared for the patients in two groups.Results The minimally invasive Wiltse admission passage MIS-TLIF was obviously better than the open TLIF surgery in the operation time,bleeding volume in operation,post-operative drainage,length of cut,walking time,hospitalization time,VAS scoring in three days after the surgery and JOA score. Within the three to six follow-up visit,there were no statistical significance in the VAS and VOS score about three months after the surgery. Conclusion Wiltse admission passage MIS-TLIF operation is characterized by such advantages as small cut,short time,little bleeding,fast recovery,few complications,etc. Through the study on early curative effects,this surgical method may receive the same curative effect as the traditional open surgery in treating the lumbar vertebra degenerative disease,and it is a safactory and effective surgical method.

关 键 词：可扩张通道 Wiltse入路 经椎间孔椎间植骨融合术 腰椎退行性疾病 

分 类 号：R681.57[医药卫生—骨科学]