Quadrant通道下微创经椎间孔腰椎椎间融合术治疗Ⅱ至Ⅲ度腰椎滑脱的临床研究  

Clinical study on minimally invasive transforaminal lumbar interbody fusion by Quadrant channel for grade Ⅱ and Ⅲ spondylolisthesis

作　　者：张思胜[1,2] 赵红卫[1,2] 肖运祥[1,2] 刘杨[1,2] 刘文俊[1,2] Zhang Sisheng Zhao Hongwei Xiao Yunxiang Liu Yang Liu Wenjun(Department of Spine Surgery, Central People＇s Hospital of Yichang City, Three Gorges University, Hubei Yichang 443002, Chin)

机构地区：[1]三峡大学脊柱医学与创伤研究所,443002 [2]湖北省宜昌市中心人民医院脊柱外科

出　　处：《中国医师进修杂志》2017年第9期776-780,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨Quadrant通道下微创经椎间孔腰椎椎间融合术（MIS-TLIF）治疗Ⅱ～Ⅲ度腰椎滑脱的临床疗效.方法 应用Quadrant通道下MIS-TLIF治疗Ⅱ～Ⅲ度腰椎滑脱48例,患者均随访12个月,观察视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、椎间隙高度及滑脱复位丢失情况.结果 患者均顺利完成手术.术后1周VAS、ODI、椎间隙高度和椎体滑脱均较术前明显改善[（4.5±0.8）分比（8.6±1.2）分、（32.0±1.3）分比（46.0±3.7）分、（10.5±2.2）mm比（4.6±2.1）mm和（2.1±2.0）mm比（11.2±1.7）mm],差异有统计学意义（P〈0.05）;与术后1周比较,术后12个月无明显变化[（2.1±2.0）分、（11.0±1.1）分、（9.8±2.5）mm和（2.2±2.0）mm],差异无统计学意义（P〉0.05）.患者未发生神经损伤、内固定物松动等并发症.结论 Quadrant通道下MIS-TLIF治疗Ⅱ～Ⅲ度腰椎滑脱是一种安全有效的微创治疗方式.Objective To observe the clinical efficacy of minimally invasive transforaminal lumbar interbody fusion （MIS-TLIF） by Quadrant channel for grade Ⅱ and Ⅲ spondylolisthesis. Methods Forty-eight patients with grade Ⅱ and Ⅲ spondylolisthesis were treated with MIS-TLIF by Quadrant channel. The patients were followed up for 12 months, The visual analog scale （VAS）, Oswestry disability index （ODI）, intervertebral height and lose drop of anterior slippage reduction were assessed. Results Surgery was successfully completed in all the patients. The VAS, ODI, intervertebral height and vertebral slippage 1 week after operation were significantly improved compared with that before operation：（4.5 ± 0.8） scores vs. （8.6 ± 1.2） scores, （32.0 ± 1.3） scores vs. （46.0 ± 3.7） scores, （10.5 ± 2.2） mm vs. （4.6 ± 2.1） mm and （2.1 ± 2.0） mm vs. （11.2 ± 1.7） mm, and there were statistical differences （P〈0.05）. Compared with that of 1 week after operation, there was no significant change in 12 months：（2.1 ± 2.0） scores, （11.0 ± 1.1） scores, （9.8 ± 2.5） mm and （2.2 ± 2.0） mm, P〉0.05. Patients did not have the complications such as nerve damage, loosening of internal fixation. Conclusions The MIS-TLIF is a safe and effective minimally invasive treatment for grade Ⅱ and Ⅲ spondylolisthesis by Quadrant channel.

关 键 词：脊椎滑脱 外科手术 微创性 QUADRANT通道 

分 类 号：R687.3[医药卫生—骨科学]