微创经椎间孔入路椎体间融合术治疗双节段腰椎管狭窄症中远期疗效  

Clinical outcomes of minimally invasive transforaminal lumbar interbody fusion fordouble⁃segment lum⁃bar spinal stenosis at mid⁃and long⁃term follow⁃up

作　　者：王晓陆[1] 刘艺明[1] 杜怡斌[1] 祁家龙 李春[1] 郑科[1] 郁贤舜[1] WANG Xiaolu;LIU Yiming;DU Yibin;QI Jialong;LI Chun;ZHENG Ke;YU Xianshun(Department of Spine Surgery,Hefei No.1 People Hospital,Hefei 230031,China)

机构地区：[1]合肥市第一人民医院,合肥230031

出　　处：《实用医学杂志》2021年第2期149-153,共5页The Journal of Practical Medicine

摘　　要：目的研究微创经椎间孔入路椎体间融合术(minimally invasive surgerytransforaminal lumbar interbody fusion,MIS⁃TLIF)治疗双节段腰椎退行性疾病中远期疗效。方法选取2013年12月至2015年12月在我科诊治的62例双节段退行性腰椎管狭窄症患者,根据不同手术治疗方法将患者分为MIS⁃TLIF组32例和开放经椎间孔入路椎体间融合(open transforaminal lumbar interbody fusion,O⁃TLIF)组30例。对术后3、6、12、24个月和末次随访(54~72个月)的Oswestry功能障碍指数(Oswestrydisability index,ODI)、疼痛视觉模拟评分(visual analogue scale,VAS)、中远期并发症等进行比较。结果在术后3、6个月时,MIS⁃TLIF组在腰痛VAS、ODI评分低于O⁃TLIF组;术后24个月和末次随访时,两组在腰痛VAS评分、下肢痛VAS评分、ODI评分差异均无统计学意义;在末次随访时,两组在VAS评分和ODI评分较术前均明显下降。邻椎病:MIS⁃TLIF组4例,O⁃TLIF组5例;椎体间融合率:MIS⁃TLIF组92.2%,O⁃TLIF组88.3%。结论MIS⁃TLIF治疗双节段退行性腰椎管狭窄症创伤小、恢复快、中远期疗效满意且并发症发生率低。Objective To study the mid⁃and long⁃term clinical efficacy of minimally invasive transforami⁃nal lumbar interbody fusion for the treatment of double⁃segment lumbar spinal stenosis.Methods Sixty⁃two patients with double⁃segment lumbar spinal stenosis who were treated in our hospital from Dec2013 to Dec2015 were retrospectively analyzed.These patients were divided into two group,MIS⁃TLIF group(32 patients)and O⁃TLIF group(30 patients).Oswestry disability index(ODI),visual analog scale(VAS)were compared between the two groups at 3 months,6 months,12 months,24 months after surgery and the latest follow⁃up.Complications and intervertebral fusion rate were also analyzed.Results Compared to O⁃TLIF group,MIS⁃TLIF group showed a significant decrease in lumbar VAS and ODI at 3 months and 6 months after surgery,but the difference was not significant between the two groups at 12 months,24 months and the latest follow⁃up.Both the two groups showed an obvious decrease in VAS and ODI at latest follow up compared to pre⁃operation.Adjacent segment degeneration was observed in 4 and 5 patients in MIS⁃TLIF and O⁃TLIF group respectively.The fusion rate in MIS⁃TLIF was 92.2%,and 88.3%for O⁃TLIF group.Conclusion MIS⁃TLIF treatment fordouble⁃segment lumbar spinal stenosis can obtain excellent medium and long⁃term outcomes,and this methoddose not increase the incidence of medium and long⁃term complications.

关 键 词：微创经椎间孔入路腰椎体间融合术 腰椎管狭窄 双节段 中远期疗效 

分 类 号：R6195[医药卫生—外科学]