后路经腰椎体间融合术的微创技术改良

发布时间：2018-06-17 00:23

  本文选题：后路腰椎体间融合术 + 微创经椎间孔椎体间融合术　； 参考：《川北医学院学报》2016年06期

【摘要】：目的:探讨采用一个切口单侧减压加对侧肌间隙入路的微创经椎间孔椎体间融合术(minimal invasive transforaminal lumbarinter bodyfusion,MIS-TLIF)治疗下腰椎疾患的临床疗效。方法:收集本院84例下腰椎退变疾病患者资料,其中53例采用MIS-TILF,31例采用传统后路经腰椎体间融合术(posterior lumbar interbody fusion,PLIF)。分析比较两组手术时间、术中出血量、术中术后并发症、术前和术后1 d肌酸激酶值、术前和末次随访时VAS评分及ODI评分。结果:MIS-TLIF组平均手术时间和术中出血量分别为(131.5±21.0)min、(330.6±57.6)m L;PLIF组为(148.3±27.3)min、(460.1±96.4)m L,两组比较差异有统计学意义(P0.05)。MIS-TLIF组并发症发生率及感染率显著低于PLIF组(P0.05)。两组在术前和术后1 d CPK值、术前VAS、ODI评分及末次随访ODI评分方面差异均无统计学意义(P0.05),但末次随访VAS评分MisTLIF组显著优于PLIF组(P0.05)。结论:应用单侧减压加对侧肌间隙入路的改良TLIF手术治疗腰椎退变性疾病具有微创、出血少、手术时间短、并发症低、医患辐射少、无需特殊器械等优点,是一种安全有效的微创术式。
[Abstract]:Objective: To explore the clinical effect of minimally invasive transforaminal interbody fusion (minimal invasive transforaminal lumbarinter bodyfusion, MIS-TLIF) on the treatment of lower lumbar disease by unilateral decompression of a unilateral incision and contralateral interspace approach (MIS-TLIF). Methods: 84 cases of lower lumbar degenerative disease were collected in our hospital, of which 53 cases were used MIS-TILF, 31 cases. Using the traditional posterior lumbar interbody fusion (posterior lumbar interbody fusion, PLIF), the operation time, intraoperative bleeding, postoperative complications, preoperative and postoperative 1 D kinase value, VAS score and ODI score at preoperative and last follow-up were compared between the two groups. Results: the average operation time and the amount of intraoperative bleeding were (131) in group MIS-TLIF, respectively (131 .5 + 21) min, (330.6 + 57.6) m L, PLIF group (148.3 + 27.3) min, (460.1 + 96.4) m L, and two groups were statistically significant (P0.05).MIS-TLIF group complication rate and infection rate were significantly lower than PLIF group (P0.05). Two groups were not statistically significant before and after operation 1. 0.05), but the last follow-up VAS score in group MisTLIF was significantly better than that in group PLIF (P0.05). Conclusion: the modified TLIF operation with unilateral decompression and contralateral interspace approach is a safe and effective minimally invasive procedure for the treatment of lumbar degenerative disease with minimally invasive, less bleeding, shorter operation time, less complications, less radiation and no special equipment.
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