Quadrant系统联合Viper经皮椎弓根螺钉固定PLIF技术治疗腰椎退变的疗效分析  

The clinical effect of Quadrant system combined with Viper percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases through PLIF technique

作　　者：黎俊[1] 瞿玉兴[2] 赵洪[2] 高益[2] 彭立波[2] 

机构地区：[1]南京中医药大学第一临床医学院,南京210000 [2]南京中医药大学附属常州中医院骨一科,江苏常州213000

出　　处：《颈腰痛杂志》2016年第1期28-31,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的研究运用经Quadrant通道系统下行椎问盘摘除、椎管减压、椎体间融合联合经皮Viper椎弓根螺钉内固定技术治疗腰椎退行性疾病的安全性和有效性。方法2012—01—2013—12收住入院腰椎退变患者23例，男10例，女13例，年龄42—77岁，平均58．8岁。所有患者均采用经Quadrant通道系统下行椎问盘摘除、椎管减压、椎体间融合联合经皮Viper椎弓根螺钉固定术治疗，术后定期随访观察腰腿痛VAS评分、ODI指数及Maenab评级了解手术疗效。结果手术时间120～215min，平均160．8min；出血量100～200ml，平均138．4ml；所有患者均一期愈合；术后住院7～12d，平均8．2d；术前腰痛VAS评分（5．39±1．30）分，术后（2．74＋0．86）分；术前腿痛VAS评分（7．52±0．73）分，术后（4．13±0．92）分；术前ODI指数（69．65±8．56）分，术后（46．26±6．55）分；所有患者最少随访12个月。根据Macnab评级，优15例（65．2％），良8例（34．8％）。结论Quadrant系统联合经皮Viper椎弓根螺钉固定技术具有创伤小、出血量少、恢复时间短、疗效好等优点，但其对于手术医生的技术要求较高，操作过程中需要谨慎，尤其需要注意避免损伤硬脊膜。Objective To study the safety and effect of surgical treatment with lumbar disc re- moved,spinal canal decompression,interbody fusion using Quadrant operation system,and percuta- neous pediele screw fixation using Viper system in patients with lumbar degenerative diseases. Methods From January 2012 to December 2013,23 patients with lumbar degeneration were admit- ted to hospital （including 10 males and 13 females）,aged from 42 to 77 years, average age was 58.8 years. All patients were treated with lumbar discectomy,spinal canal deeompression,interbody fusion using Quadrant operation system and percutaneous pedicle screw fixation using Viper operation system. Postoperative regular follow-up included lumbocrural pain VAS score,ODI index and Macnab rating, which were used to evaluate the operation effect. Results The average operative time was 160.8 min（ranged 120-215 min）. The average amount of blood loss was 138.4 ml（ranged 100-200 ml）. All patients achieved one-stage incision healing. The average hospitalization time was 8.2 days（ranged 7-12 days）. Preoperative low back pain VAS score was （5.39±1.30）,postoperative low back pain VAS score was （2.74±0.86）. Preoperative leg pain VAS score was （7.52±0.73）,postoperative leg pain VAS score was （4.13±0.92）. Preoperative ODI was （69.65±8.56）, postoperative ODI was（46.26±6.55）. All patients were followed up for a minimum of 12 months. According to Macnab rating, the clinical effect was excellent in 15 eases （65.2%）, good in 8 eases （34.8%）. Conclusion The Quadrant system combined with percutaneous pedicle screw fixation using Viper system has the advantages of less trauma, less bleeding,shorter recovery time, but the surgeons need to be more skillful and cautious,especially need to pay attention to avoid the damage of the dural when in this operation.

关 键 词：QUADRANT系统 Viper经皮固定系统 PLIF技术 腰椎退变 

分 类 号：R687.32[医药卫生—骨科学]