单侧MIS-TLIF治疗极外侧腰椎间盘突出症  

Unilateral MIS-TLIF for extreme lateral lumbar disc herniation

作　　者：于圣会[1] 罗干 陈果 张学磊 顾祖超[1] YU Sheng-hui;LUO Gan;CHEN Guo;ZHANG Xue-lei;GU Zu-chao(Department of Orthopaedics,Chengdu First People’s Hospital,Chengdu 610041,China)

机构地区：[1]成都市第一人民医院骨科

出　　处：《中国矫形外科杂志》2019年第21期1926-1930,共5页Orthopedic Journal of China

基　　金：四川省卫计委普及应用项目（编号：18PJ479”）

摘　　要：[目的]探讨应用单侧MIS-TLIF及单侧内固定治疗极外侧腰椎间盘突出症(FLLDH)的临床疗效。[方法]回顾性分析2012年6月~2016年3月,采用单侧MIS-TLIF及单侧内固定治疗的外侧腰椎间盘突出症患者37例,男18例,女19例,年龄41~76岁,平均(59.42±8.81)岁。采用疼痛视觉模拟评分(VAS评分)和功能障碍指数(ODI),以及影像学资料评价临床疗效。[结果]本组病例均顺利完成手术,手术时间70~130 min,出血量80~150 ml,术中无硬膜囊、神经根损伤。术后随访14~35个月,平均(22.13±4.82)个月。术后腰痛VAS评分、腿痛VAS评分及ODI评分,均较术前显著降低(P<0.05),且术后随时间推移上述评分进一步显著降低(P<0.05)。术后X线片随访显示内固定位置良好,术后9~15个月,平均(13.31±2.73)个月,达到椎间骨性融合。术后3例患者椎间高度有丢失,高度丢失率8.12%。无内固定松动、移位、脱落等并发症。[结论]单侧MIS-TLIF及单侧内固定治疗极外侧腰椎间盘突出症具有手术创伤小、术中出血量少、手术时间短、并发症少、恢复快等优点。[Objective] To investigate the clinical outcomes of unilateral minimal invasive surgery-transforaminal lumbar interbody fusion(MIS-TLIF) for extreme lateral lumbar disc herniation(ELLDH). [Methods] A retrospective study was conducted on 37 patients who underwent unilateral MIS-TLIF for extreme lateral lumbar disc herniation(ELLDH) from June 2012 to March 2016, including18 males and 19 females aged 41~76 years with an average age of(59.42± 8.81) years. The visual analogue scale(VAS) for pain, the Oswestry Disability Index(ODI) and imaging data were used to evaluate the clinical outcomes.[Results] All the patients had operation performed successfully with operation time of 70~130 minutes and intraoperative blood loss of 80~150 ml, whereas without serious complications,such as dural tear and nerve injuries. The follow-up period ranged from 14 to 35 months, with an average of(22.13±4.82) months. The VAS scores of low back pain and leg pain, as well as ODI score significantly decreased postoperatively compared with those before operation(P<0.05), which further significantly decreased over time postoperatively(P<0.05). In term of radiographic assessment, all the patients had the implants placed in the proper position postoperatively, and achieved bony fusion in 9 to 15 months with an average of(13.31±2.73)months. Except of intervertebral height loss found in 3 patients with a loss rate of 8.82%, no other deteriorated radiographic phenomena, such as loosening, or displacement of the implants, were noted in anyone of them at the latest follow up. [Conclusion]This unilateral MIS-TLIF for extreme lateral lumbar disc herniation has the advantages of shortening operation time, reducing bleeding, minimizing iatrogenic trauma, reducing complications and improving recovery.

关 键 词：极外侧型腰椎间盘突出症 微创通道 内固定 治疗结果 

分 类 号：R681.53[医药卫生—骨科学]