斜外侧椎间融合术治疗腰椎结核  

Oblique lateral interbody fusion for lumbar tuberculosis

作　　者：张文辉 张汉国[1,2] 何宗儒 杨玉平 杨风光 贾斌 路明东 郭士方 钱耀文[1,2] 刘杰 ZHANG Wen-hui;ZHANG Han-guo;HE Zong-ru;YANG Yu-ping;YANG Feng-guang;JIA Bin;LU Ming-dong;GUO Shi-fang;QIAN Yao-wen;LIU Jie(Peopled Hospital of Gansu Province,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院,甘肃兰州730000 [2]天水市中西医结合医院,甘肃天水741000

出　　处：《中国矫形外科杂志》2021年第23期2182-2185,共4页Orthopedic Journal of China

基　　金：甘肃省青年科技基金项目(编号:20JR10RA414)。

摘　　要：[目的]介绍斜外侧椎间融合术治疗腰椎结核的手术技术和初步结果。[方法]2018年10月-2020年6月,本院骨科收住腰椎结核患者13例,采用斜外侧椎间融合术治疗。取侧卧位,经腹外斜肌、腹内斜肌、腹横肌进人腹膜外间隙,抵达腰椎侧方,清除病灶,取髂骨植骨,最后行椎体钉内固定。[结果]手术时间平均(132.51±21.40)min,术中出血量(227.32±43.14)ml。术后7 d,血沉(elythocyte sedimentation late,ESR)、C反应蛋白(Oreactive protein,CRP)、VAS评分(visual analogue scale,VAS)均较术前显著改善,差异均有统计学意义(P<0.05)。术后患者神经功能改善,无明显并发症。[结论]斜外侧椎间融合术治疗腰椎结核是一种新的微创手术方式,具有创伤小、手术时间短、出血量少、病灶清除彻底、安全有效的优点。[Objective]To introduce the surgical technique and preliminary results of oblique lateral interbody fusion(OLIF)in the treatment of lumbar tuberculosis.[Methods]From October 2018 to June 2020,13 patients undenvent OLIF for lumbar tuberculosis in our hospital.The patients were placed in lateral decubitus position,and a small incision was made to expose the lesion by dissection of the external oblique,internal oblique and transverse abdominis muscles to enter into the extraperitoneal space,and reach the side of the affected lumbar vertebrae.The lesions were removed,and then iliac bone grafting was taken,and finally the vertebral body fixation was performed by using screw-rod system.[Results]The operation lasted for(132.51±21.40)min on average,associated with intraoperative blood loss of(227.32±43.14)ml,whereas without obvious complications.The ESR,CRP and VAS scores significantly improved 7 days after operation compared with those before operation(P<0.05).After surgery,the 2 patients who had nerve impairment preoperatively had neurological function improved remarkably.[Conclusion]This oblique lateral interbody fusion is a novel minimally invasive surgical technique with advantages of small trauma,short operation time,less blood loss,complete removal of lesions,high safety and effectiveness for lumbar tuberculosis.

关 键 词：斜外侧椎间融合术 腰椎结核 微创 手术入路 

分 类 号：R529.2[医药卫生—内科学]