双侧肌间隙入路经Quadrant通道下TLIF手术治疗复发性腰椎间盘突出症的临床分析  

Clinicalanalysis of TLIF in the treatment of recurrent lumbar disc herniation with bilateral muscle gap approach via quadrant channel

作　　者：翟向军 李玉华[1] 郭士业 ZHAI Xiang-jun;LI Yu-hua;GUO Shi-ye(Department of Orthopedics,Zhengzhou People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州人民医院骨科,河南郑州450000

出　　处：《颈腰痛杂志》2022年第3期381-383,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的研究双侧肌间隙入路Quadrant通道下经椎间孔入路腰椎椎体间融合术(transforaminal lumbar interbody fusion,TLIF)治疗复发性腰椎间盘突出症(lumbar disc herniation,LDH)的临床疗效。方法纳入2016年4月~2018年4月于本院治疗的44例复发性LDH患者,均采用双侧肌间隙入路经Quadrant通道下TLIF手术治疗,随访16个月以上。记录手术指标及并发症情况,观察其手术疗效。结果所有患者均成功完成手术,手术时间(125.01±21.54)min,出血量(286.76±65.03)mL,住院时间(10.29±2.05)d,随访(26.31±3.87)个月。术后3例一过性腰腿痛、1例肺部感染,无切口感染、继发神经损伤、内固定断裂等并发症;与术前相比,所有患者术后1个月、末次随访时的VAS评分、ODI指数显著下降,差异有统计学意义(P<0.05);按Macnab标准评价疗效,优28例,良13例,中3例,手术优良率93.18%。结论双侧肌间隙入路经Quadrant通道下TLIF手术治疗复发性LDH能有效解除疼痛症状,改善腰椎功能障碍,并发症发生率低,近期疗效确切。Objective To study the clinical efficacy of transforaminal lumbar interbody fusion(TLIF)in the treatment of recurrent lumbar disc herniation(LDH)with bilateral muscle gap approach via quadrant channel.Methods Forty-four patients with recurrent LDH who were treated in our hospital from April 2016 to April 2018 were selected as the study subjects,and followed up for more than 16 months.The surgical indicators and complications were recorded.Results All patients underwent successful operation.The time of surgery was(125.01±21.54)min,the amount of bleeding was(286.76±65.03)mL,hospitalization time was(10.29±2.05)d,the patients were followed up for(26.31±3.87)months.After operation,three patients complained of transient low back pain,one case with lung infection,no incision infection,secondary nerve injury,internal fixation fracture and other complications.Compared with before operation,the visual analogue score(VAS)and Oswestry dysfunction index(ODI)were significantly decreased at postoperative 1 month and the last follow-up.The differences were statistically significant(P<0.05).Macnab standard was used to evaluate the efficacy,there was excellent in 28 cases,good in 13 cases,moderate in 3 cases,poor in 0 case,the excellent and good rate of surgery was 93.18%.Conclusion TLIF in the treatment of recurrent LDH with bilateral muscle gap approach via quadrant channel can effectively relieve pain symptoms,improve lumbar dysfunction,and have a low incidence of complications,and the short-term curative effect is exact.

关 键 词：双侧肌间隙入路 QUADRANT通道 TLIF手术 复发性腰椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学]