可扩张通道辅助下微创减压融合手术治疗上腰椎退变性滑脱  

Therapeutic effects of minimally invasive decompression and fusion in treating upper degenerative spondylolisthesis through an expandable channel system

作　　者：张华[1] 王祥善[1] 梅伟[1] ZHANG Hua;WANG Xiang -shan;MEI Wei(The Third Department of Spine Surgery, Zhengzhou Orthopedics Hospital, Zhengzhou 450052, Chin)

机构地区：[1]郑州市骨科医院脊柱三科,郑州450052

出　　处：《医药论坛杂志》2018年第3期78-79,83,共3页Journal of Medical Forum

摘　　要：目的评价微创可扩张通道下减压融合手术治疗上腰椎退变性滑脱患者的临床效果。方法收集行手术减压及关节突融合的26例上腰椎退变性滑脱患者资料,所有患者均行微创通道下后路手术。手术前后及随访时填写视觉模拟量表(Visual analogue scales,VAS)和Oswestry功能障碍评分表评价腰椎及下肢疼痛及功能改善。结果术后6个月及1年随访,VAS及DOI评分显示患者腰背部疼痛及下肢疼痛症状均得到明显改善。术前ODI及VAS评分分别是(62.13±4.28)和(8.5±1.1),术后分别改善为(20.16±3.21)和(2.2±1.4),差异有统计学意义(P<0.05)。围手术期无严重并发症出现,随访过程中所有患者无内固定失败及融合不佳导致再次手术。结论上腰椎退变性滑脱的微创减压融合术后临床效果良好。可扩张通道系统的应用可以有效减少手术创伤、避免并发症的发生并促进患者术后功能改善。Objective The aim of this study was to explore therapeutic effects of minimally invasive decompression and fusion in treating upper degenerative spondylolisthesis through an expandable channel system. Methods A total of 26 consecutive patients with lumbar stenosis and degenerative spondylolisthesis were treated by decompression and facet fu- sion, using an expandable channel system. Blinded observers collected pre - and post - operative Oswestry Disability Index （ODI） and visual analogue scale （VAS） for back and leg pain scores prospectively. Results Followed up 6 months and 1 years after surgery. Analysis of leg pain VAS and DOI scores showed significant differences in improve- ment between pre- operation and follow -up. The mean pre -operative ODI, and VAS scores were 62. （13 ＋ 4. 28 ） and （8.5 ~ 1.1 ）, respectively. All mean scores improved post - operatively to （20. 16 ~3.21 ） and （2. 2 _＋ 1.4）, re- spectively. There was a statistically significant improvement in all scores （P 〈 0. 05 ）. No serious complications occurred in our study. In all cases, fusions healed well and no revision surgery was performed for failure of instrumentation during follow - up. Conclusion Minimally invasive decompression and fusion in patients with upper lumbar degenerative spon- dylolisthesis had a significant post - operative improvement in clinical results. The expandable channel system can effec- tively reduce operation trauma, prevent the complication, and promote the rehabilitation of the patients＇function.

关 键 词：上腰椎退变性滑脱 微创减压 融合 可扩张通道 

分 类 号：R681.53[医药卫生—骨科学]