两种不同术式治疗腰椎间盘突出症伴腰椎不稳的对比研究  

Comparative Study of Two Different Surgical Treatments for Lumbar Disc Herniation with LumbarInstability

作　　者：李俊 张军[1] 黄干 卢士学 许有智 朱斌[2] 方士英[1] LI Jun;ZHANG Jun;HUANG Gan;LU Shixue;XU Youzhi;ZHU Bin;FANG Shiying(Anhui West Health VocationalCollege,Lu'an 237000,China;The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]皖西卫生职业学院,安徽六安237000 [2]安徽医科大学第二附属医院,安徽合肥230601

出　　处：《皖西学院学报》2024年第2期69-74,共6页Journal of West Anhui University

基　　金：安徽省教育厅自然科学重点项目(KJ2021A1371);安徽省高校优秀人才支持项目(gxyqZD2020062)。

摘　　要：为了比较UBE-TLIF术和传统TLIF术治疗单节段腰椎间盘突出症伴腰椎不稳的早期临床疗效,回顾性分析2020年1月至2022年3月住院治疗单节段腰椎间盘突出症伴腰椎不稳的21名患者,其中12名患者接受UBE-TLIF术治疗,9名患者接受传统TLIF术。记录两组的手术时间、术中失血量、住院天数和并发症情况。分别记录两组患者术前、术后1个月、术后3个月及术后12个月腰背部、腿部视觉模拟量表(VAS)评分和Oswestry功能障碍指数(ODI)。结果显示:UBE-TLIF组和传统TLIF组术后1周时腰背部VAS评分和ODI有显著性差异(P<0.05),UBE-TLIF组的平均手术时长明显长于传统TLIF组(P<0.05),UBE-TLIF组患者术中失血量和住院天数少于传统TLIF组(P<0.05),UBE-TLIF组出现1例并发症为脑脊液漏,而传统TLIF组出现1例切口感染。结论:UBE-TLIF术不失为治疗单节段腰椎间盘突出症伴腰椎不稳一种有效的方式,相对于传统TLIF术,UBE-TLIF在术后早期即可大幅度减轻腰背痛症状,早期临床效果较好,可大幅缩短患者住院时间并早期康复。To compare the early clinical efficacy of UBE-TLIF and TLIF in the treatment of single-level lumbar disc herniation with lumbar instability,a retrospective analysis was performed on 21 patients who were hospitalized for single-level lumbar disc herniation with lumbar instability from January 2020 to August 2022.Among them,12 patients received UBE-TLIF and 9 patients received TLIF.Operation time,operative blood loss,hospital stay and complications were recorded in the two groups.Visual Analog Scale(VAS)and Oswestry Disability Index(ODI)were recorded before operation,1 month,3 months and 12 months after operation in both groups.The results show that:there were significant differences in lumbar VAS score and ODI between the UBE-TLIF group and the TLIF group at 1 week after surgery(P<0.05).The average operation time in the UBE-TLIF group was significantly longer than that in the TLIF group(P<0.05).Operative blood loss and length of stay in the UBE-TLIF group were less than those in the traditional TLIF group(P<0.05).Cerebrospinal fluid leakage was a complication in 1 case in the UBE-TLIF group,while incision infection occurred in 1 case in the traditional TLIF group.In conclusion,UBE-TLIF can be regarded as an effective method for the treatment of single segment lumbar disc herniation with lumbar instability.Compared with TLIF,UBE-TLIF can significantly reduce the symptoms of low back pain in the early postoperative period,and the early clinical effects is better than TLIF,which can significantly shorten the length of hospital stay and will recover soon.

关 键 词：单侧双通道内镜技术(UBE) 腰椎不稳症 经椎间孔腰椎椎间融合术 

分 类 号：R681.53[医药卫生—骨科学]