经椎间孔腰椎椎间融合术治疗腰椎滑脱症的效果及术后脊柱-骨盆矢状位参数的变化  

Efficacy of transforaminal lumbar interbody fusion for lumbar spondylolisthesis and changes in postoperative spinal-pelvic sagittal parameters

作　　者：刘叶[1] 张宏志[1] 申海波[1] 赵洪双[1] 张隆[2] LIU Ye;ZHANG Hong-zhi;SHEN Hai-bo;ZHAO Hong-Shuang;ZHANG Long(The First Department of Orthopaedics,Shunyi Hospital of Beijing,Beijing 101300,China;Department of Orthopaedics,Hebei General Hospital,Shijiazhuang 050057,China)

机构地区：[1]北京市顺义区医院骨一科,北京市101300 [2]河北省人民医院骨科,石家庄市050057

出　　处：《广西医学》2018年第20期2392-2395,共4页Guangxi Medical Journal

基　　金：河北省科技计划项目(162777184)

摘　　要：目的探讨经椎间孔腰椎椎间融合术(TLIF)治疗腰椎滑脱症的效果及术后脊柱-骨盆矢状位参数的变化。方法回顾性分析72例腰椎滑脱症患者临床资料,均采用TLIF治疗,比较手术前后Frankel分级、Oswestry功能障碍指数(ODI)、疼痛视觉模拟量表(VAS)评分及脊柱-骨盆矢状位参数,并分析术后脊柱-骨盆矢状位参数与治疗效果的相关性。结果 72例患者均顺利完成TLIF术,术中无严重并发症发生,术后并发症发生率为16. 7%(12/72)。术后3个月,患者脊柱-骨盆矢状位参数、ODI、VAS评分均低于术前,Frankel分级优于术前(均P <0. 05)。术后脊柱-骨盆矢状位参数与ODI、VAS评分呈正相关性,而与Frankel分级呈负相关性(均P <0. 05)。结论 TLIF术治疗腰椎滑脱症安全性高,可明显改善患者临床症状及神经功能,术后脊柱-骨盆矢状位参数变化能反映其治疗效果。Objective To investigate the efficacy of transforaminal lumbar interbody fusion（TLIF） for lumbar spondylolisthesis and the changes in the postoperative sagittal-pelvic sagittal parameters. Methods The clinical data of 72 patients with lumbar spondylolisthesis undergoing TLIF were analyzed retrospectively.The preoperative Frankel grade,Oswestry Disability Index（ODI） score,Visual Analogue Scale（VAS） score and spinal-pelvic sagittal parameters were compared with the postoperative ones,and the correlation between postoperative spinal -pelvic sagittal parameters and therapeutic effect was analyzed. Results TLIF was successfully performed in the 72 patients,no severe complications occurred during operation,and the incidence rate of postoperative complications was 16.7%（12/72）.At 3 months postoperatively,the spinal-pelvic sagittal parameters,ODI score and VAS score were lower than those before operation,and the Frankel grade was superior to that before operation（all P 〈0.05）.The postoperative spinal-pelvic sagittal parameters positively correlated with the ODI score and VAS score,but negatively correlated with the Frankel grade（ P 〈0.05）. Conclusion TLIF is fairly safe in the treatment of lumbar spondylolisthesis,which can improve the patients′ clinical symptoms and neurological function significantly,and the changes in the postoperative spinal-pelvic sagittal parameters can reflect the therapeutic effect of TLIF.

关 键 词：腰椎滑脱症 经椎间孔腰椎椎体间融合术 脊柱-骨盆矢状位参数 治疗效果 

分 类 号：R681.5[医药卫生—骨科学]