MIS-TLIF联合PSF治疗腰椎退行性病的临床研究  

Clinical study of MIS-TLIF combined with PSF in the treatment of lumbar degenerative diseases

作　　者：曹峰[1] 李纯志[1] 程继伟[1] CAO Feng LI Chunzhi CHENG Jiwei(Department of Orthopedics, People＇s Liberation Army 113th Hospital, Ningbo 315040, China)

机构地区：[1]解放军第一一三医院骨科,浙江宁波315040

出　　处：《中国现代医生》2017年第24期89-93,共5页China Modern Doctor

基　　金：浙江省宁波市科学技术局市级科技计划项目(2015C50027)

摘　　要：目的研究微创经椎间孔椎间融合术(MIS-TLIF)联合椎弓根螺钉内固定术(PSF)治疗退行性腰椎侧弯患者的临床疗效。方法选择我院收治的退行性腰椎侧弯患者45例作为研究对象,均采用MIS-TLIF联合PSF治疗,比较患者手术前、手术后1周、手术后3个月、末次随访时VAS评分、SF-36评分、ODI评分、腰椎前凸角、Cobb角、冠状位躯干偏移、矢状位躯干偏移,评价患者椎体融合率和术后的减压程度。结果平均手术时间(208.54±24.55)min,平均术中出血量(327.85±42.08)mL,平均住院时间(8.54±1.04)d。术后患者的VAS评分和ODI评分明显降低(P<0.05),术后患者的SF-36评分明显升高(P<0.05)。手术后患者的腰椎前凸角、Cobb角、冠状位躯干偏移、矢状位躯干偏移均明显降低,与手术前比较差异有统计学意义(P<0.05)。术后患者的平均ODI改善率为(87.04±5.43)%,椎体的融合率90.04%,减压程度(94.05±3.87)%。结论MIS-TLIF联合PSF治疗退行性腰椎侧弯患者具有创伤小、出血量少、并发症少等特点,矫形效果佳,是治疗退行性腰椎侧弯患者的不错选择。Objective To study the clinical effect of minimally invasive transforaminal lumbar interbody fusion（MIS-TLIF） combined with pedicle screw fixation（PSF） in the treatment of degenerative lumbar scoliosis. Methods A total of 45 patients with degenerative lumbar scoliosis admitted in our hospital were enrolled in this study. All the patients were treated with MIS-TLIF combined with PSF. The VAS score, SF-36 score, ODI score, lumbar lordosis angle, Cobb angle, coronal torso offset, sagittal torso sffset were compared between the patients before surgery, at 1 week and 3 months after surgery, and at the last follow-up. The vertebral fusion rate and postoperative decompression degree were evaluated. Results The average operation time was （208.54±24.55） min, the average amount of bleeding during operation was （327.85±42.08） mL and the average hospitalization time was （8.54±1.04）days in each patient. The VAS score and ODI score of the patients were significantly decreased（P〈0.05）, and the SF-36 score was significantly increased in the postoperative patients（P〈0.05）. The lumbar lordosis angle, Cobb angle, coronal torso offset and sagittal torso sffset were significantly decreased in the patients after operation, which were significantly different from those before operation （P〈 0.05）. The average improvement rate of ODI was （87.04±5.43）%, the fusion rate of vertebral body was 90.04% and the degree of decompression （94.05±3.87）% in the postoperative patients. Conclusion MIS-TLIF combined with PSF for the treatment of degenerative lumbar scoliosis patients has less trauma, less bleeding, fewer complications and other characteristics, with good orthopedic effect, which is a good choice for the treatment of degenerative lumbar scoliosis patients.

关 键 词：微创手术 椎间孔椎间融合术 退行性疾病 腰椎侧弯 

分 类 号：R687.3[医药卫生—骨科学]