微创经椎间孔入路椎体间融合术治疗高位腰椎间盘突出症的疗效分析  

Clinical efficacy of minimally invasive surgery transforaminal lumbar interbody fusion in treatment of upper lumbar disc herniation

作　　者：谭芳 王健[1] 张锋 韩帅 宋鑫[1] 李凯 TAN Fang;WANG Jian;ZHANG Feng;HAN Shuai;SONG Xin;LI Kai(Department of Orthopedics,Pudong New Area People′s Hospital of Shanghai,Shanghai,201299;Binzhou Medical University,Yantai,Shandong,264003)

机构地区：[1]上海市浦东新区人民医院骨科,上海201299 [2]滨州医学院,山东烟台264003

出　　处：《实用临床医药杂志》2021年第12期42-45,共4页Journal of Clinical Medicine in Practice

基　　金：上海市浦东新区卫生系统学科建设项目(PWZy2020-04);上海市浦东新区卫生和计划生育委员会学科带头人培养计划任务项目(PWRd2017-08);上海市浦东新区卫生系统优秀青年医学人才培养计划项目(PWRq2020-18)。

摘　　要：目的探讨微创经椎间孔入路椎体间融合术(MISTLIF)治疗高位腰椎间盘突出症的临床疗效。方法回顾性分析12例高位腰椎间盘突出症患者的临床资料。记录手术时间、术中出血量、术后引流量、视觉模拟评分法(VAS)评分、腰椎Oswestry功能障碍指数(ODI),术后随访12个月,采用改良MacNab疗效评定标准评估临床疗效。结果12例患者均顺利接受MISTLIF,手术时间(118.33±15.86)min,术中出血量(114.17±39.42)mL,术后引流量(103.33±30.85)mL。所有患者随访均超过12个月,随访(13.50±1.31)个月。1例患者术中终板损伤,术后3个月随访时可见轻微椎间隙塌陷,术后12个月随访时可见椎间骨性融合。1例患者术后大腿前方出现麻木、疼痛等症状,6个月后好转。与术前比较,患者术后各时点VAS评分和ODI均降低,差异有统计学意义(P<0.05)。结论应用MISTLIF治疗高位腰椎间盘突出症的临床疗效满意,具有安全、有效、创伤小等优点。Objective To explore clinical efficacy of minimally invasive surgery transforaminal lumbar interbody fusion(MISTLIF)in the treatment of upper lumbar disc herniation.Methods Retrospective analysis was performed for clinical data of 12 patients with high lumbar disc herniation.The operative time,intraoperative blood loss,postoperative drainage volume,Visual Analogue Scale(VAS)score,and lumbar Oswestry disability index(ODI)were recorded.The clinical efficacy was evaluated by modified MacNab efficacy assessment criteria at the 12-month follow-up.Results All 12 patients successfully underwent MISTLIF,with operating time of(118.33±15.86)min,intraoperative blood loss of(114.17±39.42)mL,and postoperative drainage volume of(103.33±30.85)mL.All patients were followed up for more than 12 months,with follow-up time of(13.50±1.31)months.One patient had intraoperative endplate injury,slight vertebral space collapse was observed during the 3-month follow-up,and intervertebral bone fusion was achieved during the 12-month follow-up.One patient had numbness and pain in front of the thigh after surgery,which was improved after 6 months.Compared with preoperation,VAS scores and ODI of 12 patients were significantly decreased in each period after operation(P<0.05).Conclusion Application of MISTLIF in treatment of upper lumbar intervertebral disc herniation has a satisfactory clinical effect and has the advantages of safety,effectiveness,and less trauma.

关 键 词：高位腰椎间盘突出症 微创疗法 经椎间孔入路 腰椎体间融合术 

分 类 号：R61[医药卫生—外科学] R681.5[医药卫生—临床医学]