微创减压棘突间动态固定治疗腰椎退变性疾病  

Minimally invasive decompression and interspinous dynamic stabilization for lumbar degenerative diseases

作　　者：安博[1] 王衡[1] 刘英杰[1] 杜敏 郭新军 姚杰 孔凡国 朱卉敏 AN Bo;WANG Heng;LIU Ying-jie;DU Min;GUO Xin-jun;YAO Jie;KONG Fan-guo;ZHU Hui-min(Department of Spinal Surgery,Armed Police Corps Hospital of Henan Province,Zhengzhou 450000,China;Center of Minimally Invasive Spinal Surgery,Henan Orthopaedic Hospital,Zhengzhou 450000,China)

机构地区：[1]武警河南总队医院脊柱外科,河南郑州450000 [2]河南省骨科医院郑州院区脊柱微创中心,河南郑州450000

出　　处：《中国矫形外科杂志》2023年第7期660-662,共3页Orthopedic Journal of China

摘　　要：[目的]探讨微创减压棘突间动态固定治疗腰椎退变性疾病的临床疗效。[方法] 2015年1月—2017年10月,42例腰椎退变性疾病患者在全麻下行微创减压棘突间动态固定术(IntraSPINE),评价围手术期资料、随访及影像资料。[结果]所有患者均顺利完成手术,术中未出现神经损伤、脑脊液漏、椎板或棘突骨折、假体置入失败等。所有患者均获得3年以上随访,术后3个月及末次随访时腰痛VAS评分、腿痛VAS评分、ODI指数均较术前显著减少(P<0.05),改良MacNab疗效评定标准,末次随访的优良率为95.2%(40/42)。影像方面,术后3个月及末次随访时,椎间隙高度(disk height,DH)和椎间孔高度(foraminal height,FH)均较术前明显增加(P<0.05)。随访中1例出现相邻节段退变,余无其他并发症。[结论]微创减压棘突间动态固定治疗腰椎退变性疾病的疗效满意。[Objective] To evaluate the clinical outcomes of minimally invasive decompression and interspinous dynamic stabilization for lumbar degenerative diseases.[Methods] A retrospective study was conducted on 42 patients who received microdiscectomy and IntraSPINE implantation through minimally invasive Quadrant channel under general anesthesia for lumbar degenerative diseases from January2015 to October 2017.The perioperative,follow-up and radiographic documents were evaluated.[Results] All patients had operation performed successfully with operation time of(76.4±16.8) minutes,and blood loss of(59.1±14.5) ml,and were followed up for more than 3 years.The VAS and ODI scores significantly improved at 3 months postoperatively and the latest follow-up compared with those before operation(P<0.05).In addition,the excellent and good rate of clinical outcomes were marked as 95.2% based on the MacNab's criteria at the latest follow-up.In terms of radiographic assessment,the intervertebral disc height(DH) and intervertebral foraminal height(FH) significantly increased postoperatively compared with those before operation(P<0.05).During the follow-up,only 1 case of them developed adjacent segment degeneration,without other complications.[Conclusion] The minimally invasive decompression and interspinous dynamic stabilization does achieve satisfactory clinical outcomes in the treatment of lumbar degenerative diseases.

关 键 词：腰椎退变性疾病 微创手术 四方通道 显微椎间盘切除 棘突间动态固定 

分 类 号：R681.5[医药卫生—骨科学]