椎间盘镜辅助下MIS-TLIF治疗腰椎退变性疾病临床分析  

The clinical efficacy of microendoscopic-assisted MIS-TLIF in the treatment of lumbar degenerative diseases

作　　者：杨扬 周娜 马广斌[1] 高山 李鹏[1] 贾梦龙 刘铭 于龙潭 YANG Yang;ZHOU Na;MA Guangbin;GAO Shan;LI Peng;JIA Menglong;LIU Ming;YU Longtan(Department of Spinal Surgery,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China;The First Clinical Medical College,Shandong University of Traditional Chinese Medicine)

机构地区：[1]潍坊市中医院脊柱骨科,山东淮坊261041 [2]山东中医药大学第一临床医学院

出　　处：《潍坊医学院学报》2022年第3期219-221,共3页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫健委科研项目(项目编号:WFWSJK-2021-062);潍坊市卫健委中医药科研项目(项目编号:2020-4-071)。

摘　　要：目的探讨椎间盘镜辅助下微创经椎间孔腰椎椎体间融合术(MIS-TLIF)治疗腰椎退变性疾病的临床疗效。方法对潍坊市中医院2019年8月~2021年3月收治符合纳入标准的32例接受椎间盘镜辅助下MIS-TLIF治疗的腰椎退变性疾病患者的临床资料进行回顾性分析,记录围术期、随访过程和影像学资料。结果所有患者顺利完成手术,术后未出现严重并发症。手术时间平均(3.15±0.54)h、术中出血量平均(151.66±82.13)ml、术中透视次数平均(48.91±6.64)次、下地行走时间平均(2.45±0.74)d。术后随访12~23个月,平均(17.75±3.68)个月。随访过程中VAS、ODI评分均随时间呈下降趋势,随访各个时间点VAS、ODI评分较术前改善明显,至末次随访时,根据MacNab评价临床优良率为93.75%、椎间融合率为90.63%.结论椎间盘镜辅助下MIS-TLIF治疗腰椎退变性疾病具有满意的临床疗效、椎间融合率,椎间盘镜技术的应用可使手术过程更精细、准确、微创,但有一定的学习曲线与辐射暴露。Objective To investigate the clinical efficacy of microendoscopic-assisted MIS-TLIF in the treatment of lumbar degenerative diseases.Methods The clinical data of 32 patients with lumbar degenerative diseases treated with MIS-TLIF assisted by microendoscopic admitted to Weifang Hospital of Traditional Chinese Medicine from August 2019 to March 2021 were analyzed retrospectively,and the perioperative period,follow-up process and imaging data were recorded.Results All patients completed the operation successfully and there were no serious postoperative complications.The mean operative time was(3.15±0.54)h,the mean intraoperative bleeding was(151.66±82.13)ml,the mean intraoperative fluoroscopy times were(48.91±6.64),and the mean time to ambulation was(2.45±0.74)d.The patients were followed up for 12 to 23 months[mean(17.75±3.68)months].VAS and ODI scores all showed a decreasing trend over time during the follow-up,and the scores of VAS and ODI at each time point were significantly better than those before operation.At the last follow-up,the clinical excellence rate was 93.75%and the intervertebral fusion rate was 90.63%according to MacNab.Conclusion MIS-TLIF assisted by microendoscopic has good clinical effect and interbody fusion rate in the treatment of lumbar degenerative diseases.The application of microendoscopic can make the operation process more precise,accurate and minimally invasive,but it has certain learning curve and radiation exposure.

关 键 词：椎间盘镜 微创经椎间孔腰椎椎体间融合术 经皮椎弓根螺钉 腰椎退变性疾病 

分 类 号：R681.53[医药卫生—骨科学]