两种入路在腰椎椎体间融合术中对小关节突关节累及的对比研究

发布时间：2018-05-30 19:00

本文选题：小切口 + 腰椎　；参考：《浙江大学》2015年硕士论文

【摘要】：目的：对比研究Wiltse肌间隙入路与传统入路术式,在小切口经椎间孔腰椎椎体间融合(TLIF)术中,对各节段小关节突关节累及率的差别。研究设计：回顾性研究。研究对象：自2012年6月至2014年12月,应用小切口TLIF术治疗患者。观察项目：所有患者常规进行术后CT复查评估手术节段的小关节突关节累及率。方法：应用小切口TLIF术治疗一组连续的单侧下肢症状腰椎退行性病变患者共101例。减压侧统一通过传统入路,非减压侧经Wiltse肌间隙入路。术后常规CT检查评估手术节段的小关节突关节累及率。结果：共有101例连续的患者(452枚椎弓根螺钉)符合研究标准被纳入研究对象中,包括79例单节段融合、20例双节段融合和2例三节段融合。经Wiltse肌间隙入路和传统入路的小关节突关节累及率分别为26.55%和35.40%。L3、L4、L5和S1节段的小关节突关节累及率分别为16.67%、20.25%、34.90%和56.45%。结论：与传统入路相比,经Wiltse肌间隙入路能够提高置钉的精准度,显著降低小关节突关节累及率。同样在L5,S1节段术者也需要更加小心来避免累及到小关节突关节。
[Abstract]:Objective: to study the difference of the involvement rate of the facet joints in the small incision transforaminal lumbar interbody fusion with the traditional approach and the Wiltse intermuscular approach. Research Design: retrospective study. Participants: from June 2012 to December 2014, patients were treated with small incision TLIF. Observation items: all patients underwent routine CT reexamination to evaluate the involvement rate of facet joints. Methods: a group of 101 patients with lumbar degenerative diseases with unilateral lower extremity symptoms were treated with small incision TLIF. The decompression side was United through the traditional approach and the non-decompression side through the Wiltse approach. Postoperative routine CT scan was used to evaluate the involvement rate of facet joints. Results: a total of 101 consecutive patients with 452 pedicle screws were included in the study, including 79 cases with single segment fusion, 20 cases with double segment fusion and 2 cases with three segment fusion. The involvement rates of facet joints via Wiltse approach and traditional approach were 26.55% and 35.40%, respectively. The involvement rates of facet joints in segment L3, L4, L5 and S1 were 16.67%, 20.25%, 34.90% and 56.45%, respectively. Conclusion: compared with the traditional approach, the Wiltse approach can improve the accuracy of nail placement and significantly reduce the incidence of facet process joint involvement. Also in L _ 5 / S _ 1 segment, greater care is needed to avoid involvement of facet joints.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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