经皮内镜下腰椎后路融合术治疗腰椎滑脱症的疗效分析  

Effect of Percutaneous Endoscopic Posterior Lumbar Intervertebral Fusion in the Treatment of Mild Lumbar Spondylolisthesis

作　　者：张鹏伟 武栋泽 李旭 秦入结 ZHANG Pengwei;WU Dongze;LI Xu;QIN Rujie(Department of Spinal Surgery,Xuzhou Medical University Affiliated Lianyungang Hospital,Xuzhou,Jiangsu 222000,China;不详)

机构地区：[1]江苏省徐州医科大学附属连云港医院脊柱外科,222000 [2]江苏省徐州医科大学附属连云港医院运动医学科,222000

出　　处：《临床外科杂志》2024年第12期1315-1318,共4页Journal of Clinical Surgery

基　　金：江苏省连云港市第六期“521工程”科研项目资助计划(LYG06521202215)。

摘　　要：目的 分析经皮内镜下腰椎后路融合手术(PE-PLIF)治疗腰椎滑脱症的临床疗效,对其安全性和有效性进行评估。方法 2018年1月~2021年12月行PE-PLIF手术治疗Ⅰ度退变性腰椎滑脱病人46例,收集病人年龄、性别、体重指数(BMI)等一般资料,手术时间、出血量、透视次数等术中资料,比较术前、术后3天及术后12个月的腰腿痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分,采用Macnab标准评价病人满意度,采用Lenke分型标准评价融合情况。随访1.2~3.3年。结果 平均手术时间为(143.76±34.39)分钟,术中平均透视(6.98±0.75)次,平均住院时间(9.13±3.68)天。腰痛术前VAS评分2~9分,平均(6.14±2.79)分;术后3天VAS评分0~5分,平均(2.02±1.52)分,与术前比较,差异有统计学意义(P<0.05);术后12个月随访VAS评分0~3分,平均(1.09±0.92)分,与术后3天比较明显好转,差异有统计学意义(P<0.05)。病人下肢痛术前VAS评分4~9分,平均(6.58±2.20)分;术后3天VAS评分0~5分,平均(1.72±1.45)分,与术前比较,差异有统计学意义(P<0.05);术后12个月随访VAS评分0~3分,平均(1.13±0.95)分,与术后3天比较,差异有统计学意义(P<0.05)。病人ODI评分由术前(77.25±9.82)%降至术后12个月随访的(15.73±9.86)%,差异有统计学意义(P<0.05)。术后并发症共包含脑脊液漏3例、神经根性症状2例、滑脱不完全复位1例、内固定断裂开放手术翻修1例。按照Macnab标准评定病人满意度,优27例(58.7%)、良15例(32.6%)、一般4例(8.7%),无不良评价。结论 PE-PLIF是一种安全有效的治疗轻度腰椎滑脱症的方法。Objective analyze the clinical efficacy of percutaneous endoscopic lumbar posterior fusion(PE-PLIF)in the treatment of lumbar spondylolisthesis and evaluate its safety and effectiveness.Methods From January 2018 to December 2021,46 patients with gradeⅠdegenerative lumbar spondylolisthesis underwent PE-PLIF surgery in the Department of Orthopedics of our hospital.General data such as age,gender,body mass index(BMI),operative time,blood loss and fluoroscopy were collected.Visual analogue scale(VAS)and Oswestry Disability Index(ODI)scores were compared before surgery,3 days and 12 months after surgery to analyze the efficacy.Macnab was used to evaluate patient satisfaction,and Lenke was used to evaluate fusion.Follow-up was 1.2 to 3.3 years.Results The average operative time of the patients was(143.76±34.39)min,the average intraoperative fluoroscopy was(6.98±0.75)times,and the average hospitalization was(9.13±3.68)days.The VAS scores before low back pain ranged from 2 to 9,with an average of(6.14±2.79).The VAS score at 3 days after operation was 0-5,with an average of(2.02±1.52)points,and the difference was statistically significant compared with that before operation(P<0.05).The VAS score at 12 months after surgery was 0 to 3,with an average of(1.09±0.92)points,which was significantly improved compared with 3 days after surgery,and the difference was statistically significant(P<0.05).VAS scores of patients before lower extremity pain ranged from 4 to 9 points,with an average of(6.58±2.20)points.The VAS score at 3 days after surgery was 0-5,with an average of(1.72±1.45)points,and the difference was statistically significant compared with that before surgery(P<0.05).The VAS score at 12 months after surgery was 0~3,with an average of(1.13±0.95),and the difference was statistically significant compared with 3 days after surgery(P<0.05).ODI score of patients decreased from(77.25±9.82)%before surgery to(15.73±9.86)%after 12 months of follow-up,with statistical significance(P<0.05).Postoperative complications

关 键 词：腰椎滑脱 微创手术 后入路 腰椎融合 

分 类 号：R68[医药卫生—骨科学]