一次性可透视扩张通道在治疗腰椎疾患中的可行性分析  

The Feasibility Analysis of Disposable Radiolucent Expansion Tube System in the Treatment of Lumbar Disc Herniation

作　　者：张大鹏[1] 毛克亚[2] 强晓军[1] 

机构地区：[1]濮阳市油田总医院骨一科,河南濮阳457001 [2]解放军总医院骨二科,北京100853

出　　处：《实用骨科杂志》2016年第7期582-585,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨一次性可透视s-tube及LED光源系统辅助微创经椎间孔入路腰椎椎体间融合术(minimally invasive surgery transforaminal lumbar interbody fusion,MIS-TLIF)治疗腰椎间盘突出症的优势。方法收集我院2014年1月至2015年1月采用一次性可透视S-tube系统辅助MIS-TILF术式治疗腰椎间盘突出症患者共54例,进行回顾性研究。记录手术时间、术中出血量、术中透视次数及下地时间、术中透视及术后2 d复查发现内置物位置不佳次数;采用疼痛视觉模拟评分(visual analogue scale,VAS)评估手术前后腰腿痛程度;采用Oswestry功能障碍指数评分(oswestry disability index,ODI)评估手术前后腰椎功能。根据术后1年正侧位X线片,采用Bridwell方法评价腰椎融合情况。结果术后随访时间为12个月。手术时间平均74 min,术中出血量平均95 m L,术中透视次数平均12次,术后下地时间平均1.7 d。术中透视发现内置物位置不佳共5例(9.2%),术后各时间点腰痛、腿痛VAS评分及ODI评分均较术前明显改善,差异有统计学意义(P<0.05),末次随访时所有患者均获得椎间骨性融合。结论一次性可透视s-tube及LED光源系统辅助MIS-TLIF治疗腰椎间盘突出症效果可靠,并具有透视性佳、费用低等优点。Objective To discuss the advantages of MIS-TLIF which assisted by the disposable radiolucent tube system in treating lumbar disc herniation. Methods From January 2014 to 2015 January,a total of 54 cases of lumbar disc herniation in our hospital were collected. All of them underwent MIS-TLIF assisted by the disposable radiolucent tube and LED light system.The surgery time,intraoperative blood loss,X-ray exposure time,bed time and built in poor location were record. The Oswestry Disability Index（ ODI）,back and leg pain Visual Analogue scores（ VAS）,and X-ray examination were performed before surgery,after surgery and during follow-up. Results The follow-up time was 12 months. The average operation time was 74 min,the average blood loss was 95 m L,the average number of intraoperative X-ray was 12 times,the average time was 1. 7 days. A total of 5 cases（ 9. 2%） which built in poor location were found intraoperative X-ray. The postoperative VAS score and ODI score were significantly improved compared with the preoperative,the difference was statistically significant（P〈0. 05）. All patients got bony fusion at the end of the follow-up. Conclusion MIS-TLIF assisted by the disposable radiolucent tube system in the treatment of lumbar disc herniation is effective and have the advantages of good x-ray image and low cost.

关 键 词：可透视 扩张通道 经椎间孔入路腰椎椎体间融合术 腰椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学]