微创通道下与椎间盘镜下联合经皮椎弓根钉TLIF治疗多节段腰椎管狭窄症疗效对比

发布时间：2018-07-09 12:26

本文选题：微创通道 + 椎间盘镜　；参考：《广东医学》2017年13期

【摘要】：目的比较分析采用微创通道(Quadrant可扩张通道)与后路椎间盘镜(MED)下治疗多节段腰椎管狭窄症的临床效果。方法采用微创通道下经皮椎弓根钉经椎间孔入路椎间融合术(TLIF)(微创通道组)治疗多节段腰椎管狭窄症,同时期采用椎间盘镜下经皮椎弓根钉TLIF(椎间盘镜组)治疗多节段腰椎管狭窄症各23例。比较两组手术时间、术中出血量、M-JOA评分、腰椎前凸角、病变椎间隙高度。结果两组手术时间差异有统计学意义(P0.05),微创通道组优于椎间盘镜组,术中出血量相比差异无统计学意义(P0.05)。术后3 d、3个月、12个月随访时:两组术后M-JOA评分、腰椎前凸角及病变椎间隙高度变化均较术前明显改善,差异有统计学意义(P0.05),两组在术后同时间段比较差异无统计学意义(P0.05)。结论使用微创通道下联合经皮椎弓根钉TLIF治疗多节段腰椎管狭窄症不但具有使用MED辅助下手术的临床效果,而且手术时间短,是一种可选择的安全、有效、微创且较MED容易掌握的手术方法。
[Abstract]:Objective to compare the clinical effects of minimally invasive channels (Quadrant expandable channels) and posterior discectomy (MED) in the treatment of multiple lumbar spinal stenosis. Methods Multi-level lumbar spinal stenosis was treated by percutaneous pedicle screw transforaminal fusion (TLIF) under minimally invasive channels. In the same period, 23 cases of multiple lumbar spinal stenosis were treated by percutaneous pedicle screw (TLIF). The operative time, blood loss and M-JOA score, lumbar kyphosis angle and height of lesion intervertebral space were compared between the two groups. Results there was significant difference in operation time between the two groups (P0.05). The microinvasive channel group was superior to the discectomy group, and the amount of intraoperative bleeding had no significant difference (P0.05). After 3 days, 3 months and 12 months follow-up: M-JOA score, lumbar kyphosis angle and the height of the lesion intervertebral space were significantly improved in the two groups (P0.05), but there was no significant difference between the two groups at the same time after operation (P0.05). Conclusion the use of minimally invasive approach combined with percutaneous pedicle screw TLIF in the treatment of multiple lumbar spinal stenosis is not only effective in the treatment of multiple lumbar spinal stenosis with MED, but also has a short operative time. It is a safe and effective method for the treatment of multiple lumbar spinal stenosis. Minimally invasive and easier to master than MED.
【作者单位】：东莞市人民医院脊柱外科;
【基金】：东莞市科技计划项目(编号:2014105101181)
【分类号】：R687.3

【相似文献】