MIS-TLIF结合钉棒系统治疗极外侧型腰椎间盘突出症的临床研究  

The Clinical Study of Minimally Invasive Transforaminal Lumbar Interbody Fusion(MIS-TLIF) with Pedicle Screw Fixation for Far Lateral Lumbar Disc Herniation

作　　者：杨智泉 党培业 樊艳梅 王彦东 邢永军 马琼[2] 韩康[3] 张伟 

机构地区：[1]陕西省榆林市星元医院(榆林市第四医院)骨2科,陕西榆林719000 [2]第四军医大学唐都医院全军骨科中心,陕西西安710038 [3]济南军区总医院脊髓修复科,山东济南250000

出　　处：《现代生物医学进展》2016年第31期6173-6176,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81201633);济南军区总医院院长基金项目(2015ZX01)

摘　　要：目的:观察和比较使用通道下经椎间孔腰椎融合术(Minimally Invasive Transforaminal Lumbar Interbody Fusion;MIS-TLIF)与常规开放手术治疗极外侧型腰椎间盘突出症的临床疗效。方法:回顾性分析2012.01至2016.01经纳入及排除标准筛选后的共计61例腰椎间盘突出症患者。根据不同的手术方法,将上述患者分别纳入实验组(MIS-TLIF组)与对照组(常规开放手术组)。对患者手术前后的疼痛程度(VAS),功能障碍程度(JOA)及各围手术期指标(出血量,手术时间,透视次数,卧床时间,花费,并发症)进行统计学比较。结果:MIS-TLIF组与对照组患者在术前的VAS评分及JOA评分的比较中无显著性差异,经外科手术后,都有显著性改善(P<0.05)且两组间无显著统计学差异(P>0.05)。但MIS-TLIF组在出血量,卧床时间,并发症等指标中都显著优于对照组(P<0.05)。结论:通道下经椎间孔腰椎融合术作为一种微创术式,能够显著改善极外侧型腰椎间盘突出症患者的临床症状,并具有其独有的优势和长处,在临床工作中可以进行进一步的使用和推广。Objective： To observe the clinical effect and safety of patients with far lateral lumbar disc herniation treated with Minimally Invasive Transforaminal Lumbar Interbody Fusion（MIS-TLIF） and tradition open-operation. Methods： The clinical and follow-up data of 61 patients from 2012.01 to 2016.01 diagnosed as far lateral lumbar disc herniation who had the operation were retrospectively analyzed. All the patients were divided into experimental group（MIS-TLIF） and control group（tradition open-operation）. The clinical outcomes were evaluated by visual analogue scale（VAS） and Japanese Orthopaedic Association Scores（JOA）, blood loss, operation time, times of X-ray, the time in bed, cost and complications and so on. Results： There was no difference between two groups in the VAS score and JOA score before and after the treatment while there were significant improvement（P〉0.05）. The blood loss, the time in bed and complications who had MIS-TLIF were significantly better compared with those in control group（P〈0.05）. Conclusions： MIS-TLIF as a MISS operation in the treatment of far lateral lumbar disc herniation has more particular advantages than normal treatments, which should be further application and promotion in clinic.

关 键 词：腰椎间盘突出症 经椎间孔腰椎融合术 疼痛 

分 类 号：R681.53[医药卫生—骨科学]