经肌间隙入路椎间孔椎体间融合术治疗腰椎滑脱症  

Transforaminal lumbar interbody fusion through paraspinal approach for the treatment of lumbar spondylolisthesis

作　　者：沈洪弟 崔烨平 魏志祥[1] 程毅[1] 王雷[2] 

机构地区：[1]昆山市第三人民医院骨科,江苏昆山215300 [2]上海交通大学附属第一人民医院脊柱外科,上海200080

出　　处：《临床骨科杂志》2016年第1期31-33,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较经肌间隙入路椎间孔椎体间融合术（TLIF）与常规TLIF治疗Ⅰ、Ⅱ度腰椎滑脱的临床疗效。方法将50例Ⅰ、Ⅱ度腰椎滑脱患者按随机数字表法分为常规TLIF手术组（常规组,25例）和经肌间隙入路TLIF手术组（研究组,25例）。记录手术时间、术中出血量、伤口引流量,观察术后14 d疼痛视觉模拟评分（VAS）、术后3个月Oswestry功能障碍指数（ODI）,评价术后6个月融合率、术后12个月临床疗效满意率。结果患者均获得随访,时间12~24个月。手术时间、术中出血量、伤口引流量、术后14 d VAS评分、术后3个月ODI评分研究组均优于常规组,差异均有统计学意义（P〈0.05）;术后6个月融合率、术后12个月临床疗效满意率两组比较差异均无统计学意义（P〉0.05）。结论经肌间隙入路TLIF治疗Ⅰ、Ⅱ度腰椎滑脱近期疗效可靠。Objective To compare the clinical effect of transforaminal lumbar interbody fusion（ TLIF） through paraspinal approach with traditional approach for the treatment of degree Ⅰ,Ⅱ of lumbar spondylolisthesis. Methods50 patients suffering from lumbar spondylolisthesis with the degree Ⅰ,Ⅱ were randomly divided into two groups.25 patients were underwent conventional TLIF surgery（ conventional group） and other 25 patients were underwent TLIF surgery through paraspinal approach（ research group）. The operative time,intraoperative blood loss and surgical wound drainage were compared between two groups. VAS（ 14 d postoperation）,ODI（ 3 months postoperation） evaluating standards were applied to evaluate the therapeutic effect. The intervertebral fusion rate were observed in 6 months after surgery,the clinical satisfaction rate in 12 months postoperation were evaluated. Results All cases were followed up for 12 ~ 24 months. The operative time,intraoperative blood loss,wound drainage,VAS（ 14 d postoperation）,ODI（ 3 months postoperation） in research group were better than the conventional group（ P〈0. 05）; But there was no significant difference in fusion rate of 6 months and satisfaction rate of clinical efficacy in 12 months（ P〈0. 05）. Conclusions TLIF through paraspinal approach technique can provide a reliable short-term effect in the treatment of lumbar spondylolisthesis.

关 键 词：经肌间隙入路 经椎间孔椎体间融合术 腰椎滑脱症 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]