Luxor通道系统下微创手术与传统手术治疗单节段腰椎间盘突出症的临床分析

发布时间：2018-06-16 16:21

本文选题：腰椎间盘突出症 + Luxor通道管系统　；参考：《吉林大学》2015年硕士论文

【摘要】：目的：腰椎间盘突出症是骨科的常见病之一。本症首选的治疗方案为保守治疗，当保守治疗无效时行手术治疗，，传统的术式多采用开放性手术，近年来，随着微创技术在脊柱外科手术中的开展，通道系统已应用于临床治疗中，辅以影像学的个体化术前设计也得到越来越多的关注。本研究比较了LUXOR可扩张通道系统与传统开放性手术在治疗腰椎间盘突出症的优缺点，并探讨影像学个性化术前设计的应用价值。方法：回顾性分析吉林大学第二医院骨科医院脊柱外科2013年8月～2014年12月收治的29例单节段腰椎间盘突出症患者，其中9例采用LUXOR可扩张通道管系统治疗设立为观察组，其余20例行传统开放式手术设为对照组。对两组病例的切口长度、术中出血量、手术时间、术后下床活动时间、住院时间、有无并发症发生和术后下腰部疼痛进行比较，全部患者均由同一位教授完成手术操作，且上述29例患者的VAS、JOA和Macnab评分均由同一位医师完成。结果：切口长度（cm）：观察组＜对照组；手术时间（min）：观察组＜对照组；术后下床时间（d）：观察组＜对照组；平均住院天数（d）：观察组＜对照组；术后并发症：观察组＜对照组。以上各组比较，差异有统计学意义（P＜0.05）。观察组和对照组的术后下腰部疼痛差异无统计学意义（P＞0.05）。两组术后Macnab疗效优良率差异无统计学意义（P＞0.05）。结论：1、微创通道下手术和传统开放手术治疗腰椎间盘突出症的疗效并无明显统计学差异；2、严格掌握手术适应证和禁忌症的前提下，Luxor可扩张通道管系统下进行手术与传统开放式手术对于腰椎间盘突出症的治疗均能解决神经压迫症状，达到预期效果，Luxor可扩张通道系统下手术具有创伤小、出血少、切口小、功能恢复快和早期下床活动的特点；3、根据影像学资料进行术前手术设计有助于精确定位、减少失误。
[Abstract]:Objective: lumbar disc herniation is one of the common diseases in orthopaedics. The first choice of treatment for this disease is conservative treatment. When the conservative treatment is not effective, the traditional surgical methods are mostly open surgery. In recent years, with the development of minimally invasive techniques in spinal surgery, Channel system has been used in clinical treatment and individualized preoperative design with imaging has been paid more and more attention. This study compared the advantages and disadvantages of LUXOR expandable channel system with traditional open surgery in the treatment of lumbar disc herniation and discussed the application value of individualized preoperative design of imaging. Methods: a retrospective analysis of 29 patients with single segment lumbar disc herniation from August 2013 to December 2014 in Department of Spinal surgery, Orthopaedics Hospital, second Hospital of Jilin University was performed. Among them, 9 cases were treated with LUXOR expandable canal system as the observation group. The other 20 cases were treated with traditional open operation as control group. The length of incision, the amount of blood lost during operation, the time of getting out of bed, the time of hospitalization, the occurrence of complications and the pain of lower back after operation were compared between the two groups. All the patients were operated by the same professor. The VASV JOA and Macnab scores of 29 patients were performed by the same physician. Results: the length of incision was: observation group < control group; operation time: observation group < control group; postoperative time of getting out of bed: observation group < control group; average days of hospitalization: observation group < control group; postoperative complication: observation group < control group. The difference was statistically significant (P < 0.05). There was no significant difference in lower back pain between the observation group and the control group (P > 0.05). There was no significant difference in the effective rate of Macnab between the two groups (P > 0.05). Conclusion there is no significant difference in the curative effect between minimally invasive surgery and traditional open surgery in the treatment of lumbar disc herniation. 2. Under the premise of strictly mastering the indications and contraindications of surgery, both Luxor and traditional open surgery can solve the symptoms of nerve compression in the treatment of lumbar disc herniation. In order to achieve the desired results, Luxor can expand the system of surgery with less trauma, less bleeding, small incision, quick functional recovery and early movement out of bed. Preoperative surgical design based on imaging data is helpful for accurate location and reduction of errors.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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