Wiltse入路单侧TLIF对极外侧型腰椎间盘突出症效果  

CLINICAL EFFICACY OF TRANSFORAMINAL LUMBAR INTERBODY FUSION THROUGH WILTSE APPROACH FOR THE TREATMENT OF EXTREME LATERAL LUMBAR DISC HERNIATION

作　　者：高建文[1] 张科峰[1] 陆继收[1] 

机构地区：[1]济宁市第一人民医院脊柱外科,山东济宁272000

出　　处：《齐鲁医学杂志》2016年第2期221-223,共3页Medical Journal of Qilu

摘　　要：目的探讨Wiltse入路单侧经椎间孔椎体融合术(TLIF)治疗极外侧型腰椎间盘突出症的临床效果。方法单间隙极外侧型腰椎间盘突出症病人92例,根据不同手术入路分为Wiltse入路组及后正中入路组,每组46例。记录两组病人手术总时间、术中出血量、术后引流量。术后随访1年,比较两组椎间融合率、JOA腰痛评分及下肢痛VAS评分,观察并发症发生情况。结果 Wiltse入路组手术总时间、术中出血量、术后引流量显著少于后正中入路组(t=20.93~30.15,P<0.05)。术后1年时,Wiltse入路组JOA及VAS评分显著优于后正中入路组(t=3.73、5.10,P<0.05),而两组椎间融合率差异无显著性(P>0.05)。两组均未出现脑脊液漏、神经根损伤、切口感染等并发症。结论两种入路治疗极外侧型腰椎间盘突出症椎间融合率相近,但Wiltse入路创伤更小,术后腰背痛的发生率更低。Objective To assess the clinical efficacy of transforaminal lumbar interbody fusion （TLIF） through Wiltse approach for extreme lateral lumbar disc herniation （ELLDH）. Methods Ninety-two patients with ELLDH were enrolled and equally divided into Wiitse approach group and posterior-midline （PM） approach group. Total operation time, blood loss at surgery and postoperative drainage volume were recorded. The patients were followed for one year after surgery. Intervertebral fusion rate, Japanese Orthopaedics Association （JOA） score for lower back pain and Visual Analogue Acale （VAS） for lower extremity pain were compared between the two groups. The complications were observed. Results The operation time, blood loss at surgery and postoperative drainage volume in Wiltse approach group were much less than that in PM approach group （t = 20.93--30.15, P^0.05）. One year after surgery, the JOA score and VAS score in Wiltse approach group were superior to PM approach group （t=3.73,5.10;P^O.05）, and the difference in intervertebral fusion rate between the two groups was not significant （P^0.05）. No complications--such as eerebrospinal fluid leakage, nerve root injury or wound infection--were noted in the two groups. Conclusion The intervertebral fusion rate in both Wiltse approach and posterior-midline approach was similar for extreme lateral lumbar disc herniation, but less trauma and postoperative back pain are experienced in patients undergoing surgery through Wiltse ap- proach.

关 键 词：腰椎 椎间盘移位 外科手术 治疗结果 

分 类 号：R681.53[医药卫生—骨科学]