改良侧方腰椎椎间融合术在腰椎邻近节段退变手术中的应用  

Application of modified lateral lumbar interbody fusion in lumbar adjacent segment degeneration

作　　者：邓俊森 张迪 张文明 李俊辉 DENG Jun-sen;ZHANG Di;ZHANG Wen-ming;LI Jun-hui(Department of Pelvic Surgery,Luoyang OrthopedicHospital of Henan Province(Henan Orthopedic Hospital),Henan,450000,China;Department of Spinal Surgery,Luoyang OrthopedicHospital of Henan Province(Henan Orthopedic Hospital),Henan,450000,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)骨盆外科,河南郑州450000 [2]河南省洛阳正骨医院(河南省骨科医院)脊柱外科,河南郑州450000

出　　处：《颈腰痛杂志》2023年第3期373-375,468,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的观察改良侧方腰椎椎间融合术(crenel lateral interbody fusion,CLIF)在腰椎邻近节段退变性疾病(adjacent segment degenerative disease,ASD)治疗中的临床疗效。方法将2018年6月~2019年6月采用CLIF手术治疗的37例腰椎ASD患者纳入研究,其中男13例,女24例。分别于术前、术后2周、术后3个月及末次随访时进行疗效评价。结果与术前相比,患者术后2周、术后3个月及末次随访时的VAS评分、ODI指数、腰椎前凸角(lumbar lordosis,LL)、节段前凸角(segmental lordosis,SL)、椎间隙高度、椎间孔高度及椎管面积均获显著改善,差异均有统计学意义(P<0.05);与术后2周相比,患者术后3个月的VAS评分、ODI指数均进一步改善(P<0.05),但椎间隙高度、椎间孔高度也有所丢失(P<0.05);与术后3个月相比,患者末次随访时的ODI指数进一步改善(P<0.05)。结论采用CLIF手术治疗腰椎ASD临床效果显著,手术创伤小,术后恢复快,且可获得良好的LL和SL。Objective To observe the clinical effect of modifiedcrenel lateral lumbar interbody fusion(CLIF)in the treatment of lumbar adjacent segment degenerative disease(ASD).Methods Thirty-seven patients with lumbar ASD who underwent CLIF from June 2018 to June 2019 were recruited in the study,including 13 males and 24 females.The efficacy evaluation was conducted before surgery,2 weeks after surgery,3 months after surgery,and at the last follow-up.Results Compared with preoperative,the VAS score,ODI index,lumbar lordosis(LL),segmental lordosis(SL),intervertebral space height,intervertebral foramen height,and spinal canal area of patients 2 weeks after surgery,3 months after surgery,and at the last follow-up were significantly improved,with statistical significance(P<0.05);compared with 2 weeks after surgery,the VAS score and ODI index of the patient improved further 3 months after surgery(P<0.05),but there was also a loss of intervertebral space height and foramen height(P<0.05);compared with 3 months after surgery,the ODI index of patients at the last follow-up further improved(P<0.05).Conclusion CLIF for treating lumbar ASD can achieve remarkable clinical effect with less surgical trauma and rapid postoperative recovery,which canget good LL and SL.

关 键 词：改良侧方腰椎椎间融合术 腰椎退变性疾病 邻近节段退变 腰椎后路减压融合术 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]