全内镜大通道单侧入路双侧减压椎间植骨融合术治疗单节段腰椎滑脱症:与传统PLIF手术比较  

Treatment of bilateral decompression interbody graft fusion with the unilateral approach Single-level lumbar spondylolisthesis:compared with conventional PLIF surgery

作　　者：李景龙[1] LI Jing-long(Anyang People′s Hospital of Henan Province,Anyang,Henan Province 455000,China)

机构地区：[1]河南省安阳市人民医院骨二科,河南安阳455000

出　　处：《颈腰痛杂志》2024年第3期463-466,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的 比较分析全内镜大通道单侧入路双侧减压与传统后路切开腰椎椎体间融合术(PLIF)治疗单节段Ⅰ、Ⅱ度腰椎滑脱症的临床疗效。方法 回顾性分析2019年3月至2022年2月于安阳市人民医院住院的单节段腰椎滑脱症患者,其中行全内镜大通道单侧入路双侧减压椎体间融合术的35例为观察组,行传统PLIF手术的47例为对照组。比较两组患者手术一般情况,术后VAS评分和ODI评分,以及随访2年椎间融合率和并发症等指标。结果 术后随访2年,观察组手术时间、术中出血量、切口长度、术后引流量和住院时间均少于对照组;观察组术后各时间节点的VAS评分和ODI评分均低于对照组,差异均有统计学意义(P<0.05)。两组术后2年椎间融合率和并发症方面,差异无统计学意义(P>0.05)。结论 全内镜大通道单侧入路双侧减压椎间植骨融合术治疗单节段腰椎滑脱症,术后疗效确切,椎间融合率高,且创伤小、出血少、手术时间短、术后功能恢复好,手术并发症少,为脊柱内镜治疗腰椎滑脱症提供了临床依据。Objective To comparatively analyze the clinical efficacy of full endoscopic large channel unilateral approach for bilateral decompression and traditional posterior incision lumbar interbody fusion(PLIF)in the treatment of single segmentⅠandⅡdegree lumbar spondylolisthesis.Methods Retrospective analysis was made on the patients with single level lumbar spondylolisthesis hospitalized in Anyang People’s Hospital from March 2019 to February 2022.Among them,35 cases were treated with bilateral decompression and interbody fusion through the single side approach of the full endoscope large channel as the observation group,and 47 cases were treated with traditional posterior incision and interbody fusion as the control group.The general surgical condition,postoperative VAS score and ODI score,as well as the 2-year follow-up of intervertebral fusion rate and complications were compared between the two groups of patients.Results After a follow-up of 2 years,the observation group had shorter surgical time,intraoperative bleeding,incision length,postoperative drainage volume,and hospital stay than the control group;The VAS score and ODI score of the observation group at various time points after surgery were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in intervertebral fusion rate and complications between the two groups at 2 years after surgery(P>0.05).Conclusion The treatment of single segment lumbar spondylolisthesis through full endoscopic large channel unilateral approach with bilateral decompression and bone grafting fusion has a definite therapeutic effect,high intervertebral fusion rate,minimal trauma,less bleeding,short surgical time,good postoperative functional recovery,and fewer surgical complications.This provides a clinical basis for the treatment of lumbar spondylolisthesis through spinal endoscopy.

关 键 词：全内镜 大通道 腰椎滑脱 疗效观察 

分 类 号：R687.3[医药卫生—骨科学]