微创经椎间孔腰椎间融合术治疗峡部裂型腰椎滑脱的疗效  

Efficacy of minimally invasive transforaminal lumbar interbody fusion in treating isthmic spondylolisthesis

作　　者：吕游[1] 陈鸣[1] 秦入结[1] L YU You, CHEN Ming , QIN Rujie(Department of Orthopedics, First People ＇ s Hospital of Lianyungang , Lianyungang 222000, CHIN)

机构地区：[1]连云港市第一人民医院骨科,江苏222000

出　　处：《江苏医药》2018年第3期300-304,共5页Jiangsu Medical Journal

基　　金：连云港市第一人民医院青年英才项目(QN1708)

摘　　要：目的探讨微创经椎间孔腰椎间融合术(MIS-TLIF)治疗峡部裂型腰椎滑脱的临床疗效。方法 56例单节段峡部裂型腰椎滑脱患者均分为两组,分别采用MIS-TLIF(MIS-TLIF组)与传统TLIF(Open-TLIF组)治疗,比较两组临床疗效。结果两组均顺利完成手术,手术切口一期愈合。末次随访行三维CT检查显示,MIS-TLIF组椎间融合率为96.4%(27/28),Open-TLIF组均融合。MIS-TLIF组手术时间、出血量、下床时间、住院时间及重返工作时间均少于Open-TLIF组(P<0.05),重返工作率高于Open-TLIF组(89.3%vs.82.1%)(P<0.05)。MIS-TLIF组术后腰痛VAS评分和Oswestry功能障碍指数评分均低于Open-TLIF组(P<0.05)。结论与Open-TLIF比较,MIS-TLIF治疗峡部裂型腰椎滑脱具有创伤小、手术出血少、并发症少和术后恢复快的优势。Objective To explore the clinical efficacy of minimally invasive transforaminal lumbar interbody fusion（MIS-TLIF）in treating isthmic spondylolisthesis of lumbar spine.Methods Fifty-six patients with single segment isthmic lumbar spondylolisthesis were equally divided into two groups,who were treated with MIS-TLIF（group A）and conventional open TLIF（group B）.The clinical efficacy was compared between two groups.Results The surgeries were all successful in two groups with the incision healing in first intention.The last CT scanning during follow-up showed that the rate of bone fusion was 100% in group B and 96.4% in group A.Compared to group B,group A had shorter operation time,less blood loss in surgery,earlier time for getting off bed,less hospital stay and higher rate of returning to work（89.3% vs.82.1%）（P〈0.05）.The VAS pain score of the lower back and Oswestry disability index（ODI）after surgery were lower in group A than those in group B（P〈0.05）.Conclusion Compared to conventional open TLIF, MIS-TLIF in treating isthmic spondylolisthesis has the advantages of smaller trauma,less blood loss in operation,less complications and quicker recovery.

关 键 词：经椎间孔腰椎间融合术 微创 峡部裂型腰椎滑脱 

分 类 号：R681[医药卫生—骨科学]