微创经椎间孔椎体间融合术治疗单节段腰椎退变性疾病的疗效分析  

Clinical effect of minimally invasive transforaminal interbody fusion in the treatment of single level degenerative lumbar disease

作　　者：乔林[1] 周玉萍[1] 徐军鹏 陈波 殷杰[1] 张欢 禹晓东[1] QIAO Lin;ZHOU Yuping;XU Junpeng(Department of Orthopedic,People＇s Liberation Army Third Hospital,Baoji 721004,China)

机构地区：[1]解放军第三医院骨二科,陕西宝鸡721004

出　　处：《临床外科杂志》2018年第9期702-704,共3页Journal of Clinical Surgery

基　　金：中央军委后勤保障部卫生局面上资助项目(15QN014)

摘　　要：目的探讨微创经椎间孔椎体间融合(Mis-TLIF)治疗单节段腰椎退变疾病的临床效果。方法行单节段腰椎退变疾病治疗的病人82例,按照手术方式将病人分为两组,A组40例,采用Mis-TLIF治疗。B组42例,采用开放性经椎间孔椎体间融合(Open-TLIF),比较两种手术方式的治疗效果。结果 A组手术时间为(141. 3±10. 8)分钟,术中透视(12. 0±1. 5)次,B组分别为(118. 5±10. 3)分钟和(4. 0±1. 0)次,两组比较差异有统计学意义(P <0. 05)。A组术中出血量(127. 5±1. 3) ml,术后引流量(95. 8±3. 1) ml,术后卧床时间(28. 0±1. 5)小时、术后住院时间(120. 0±2. 4)小时,无严重并发症者例数。B组分别为(320. 5±1. 2) ml、(72. 0±3. 2)小时、(144. 0±2. 1)小时、严重并发症2例,两组比较差异有统计学意义(P <0. 05)。A组病人腰痛VAS评分术后7天为(2. 0±0. 5)、术后3个月为(3. 1±0. 4),B组分别为(3. 5±0. 5)和(2. 0±0. 5),两组比较差异有统计学意义(P <0. 05)。术后18个月的评估结果中,A组无融合器移位、下沉、内固定失败,Ⅰ级与Ⅱ级融合分别为29例(72. 5%)和11例(27. 5%),B组融合器移位2例,无融合器下沉和内固定失败病人,Ⅰ级与Ⅱ级融合分别为26例(61. 9%)和16例(38. 1%)。结论在单节段腰椎退变疾病的治疗中采用MIS-TLIF方法治疗,病人创伤小,术后恢复快。Objective To investigate the therapeutic effect of minimally invasive transforaminal interbody fusion（ MIS-TLIF） in the treatment of single segment lumbar degenerative disease. Methods The data of 82 patients with single segment lumbar degeneration disease were divided into two groups：group A（ n = 40） were treated by minimally invasive transforaminal interbody fusion（ MIS-TLIF）,group B（ n = 42） were treated by open intervertebral foramen interbody fusion（ Open-TLIF）. Compared the efficacy of the two surgical methods. Results Operation time of group A was（ 141. 3 ± 10. 8） minutes,intraoperative fluoroscopy was（ 12. 0 ± 1. 5）,while the data of group B were（ 118. 5 ± 10. 3） minutes and（ 4. 0± 1. 0）,respectively（ both P〈0. 05）. In group A,intraoperative blood loss was（ 127. 5 ± 1. 3） ml,postoperative drainage was（ 95. 8 ± 3. 1） ml,postoperative bed time was（ 28. 0 ± 1. 5） hours,postoperative hospital stay was（ 120. 0 ± 2. 4） hours and the number of cases without serious complications. The data of group B were（ 320. 5 ± 1. 2） ml,（ 72. 0 ± 3. 2）,（ 144. 0 ± 2. 1） hours,,respectively. Severe complication was happened in 2 cases. There were statistical significance between the two groups（ P〈0. 05）. Waist pain VAS scores of 7 days and 3 months after surgery of group A were（ 2. 0 ± 0. 5） and（ 3. 1 ± 0. 4）,respectively. While the data of group B were（ 3. 5 ± 0. 5） and（ 2. 0 ± 0. 5）,respectively. There were statistical significance between the two groups（ P〈0. 05）. After 18 months of evaluation results in group A without translocation and sinking of fusion and internal fixation failure,Ⅰ level and Ⅱ level fusion were 29 cases（ 72. 5%） and 11 cases（ 27. 5%）,respectively. group B fusion shift happeded in 2 cases,no sink fusion and internal fixation failure patients,Ⅰ level and Ⅱ level fusion were 26 cases（ 61. 9%） and 16 cases（ 38. 1%）,respectively. Conclusion The MIS-TLIF method in the trea

关 键 词：微创经椎间孔椎体间融合 开放性经椎间孔椎体间融合 单节段腰椎退变疾病 

分 类 号：R687.3[医药卫生—骨科学]