微创与开放经椎间孔椎间融合术治疗腰椎滑脱症的临床对比研究

发布时间：2018-07-24 12:04

【摘要】：目的对比Mast Quadrant微创系统下经椎间孔椎间融合术(Mini-TLIF)与传统开放经椎间孔椎间融合术(Open-TLIF)治疗腰椎滑脱症的临床疗效。方法回顾分析40例单节段腰椎滑脱症患者,Quadrant后路微创撑开系统辅助下行经椎间孔椎间融合术20例为微创组,开放腰椎后路经椎间孔椎间融合术20例为开放组。收集患者围手术期的资料,包括切口长度、术中出血量、引流量、手术时间和术后下床活动时间等。对所有患者术前、术后2周、2个月、1年、2年进行VAS及ODI评分并记录。比较微创组与开放组患者之间的疗效。结果微创组在切口长度、出血量、术后下床活动时间等方面优于开放组,差异有统计学意义(P0.01);但微创组手术时间长于开放组(P0.05)。两组患者术后VAS、ODI评分均呈下降趋势,术后各时点评分与术前比较差异均具有统计学意义(P0.01)。微创组术后VAS、ODI评分下降幅度较开放组下降幅度大,差异具有统计学意义(P0.01)。术后2周VAS、ODI评分,微创组优于开放组(P0.01)。结论 Mast Quadrant微创系统下经椎间孔椎间融合术与开放腰椎后路经椎间孔椎间融合术比较,具有切口小、术中及术后出血量少、术后下床活动时间早、短期临床疗效显著等优点。只要严格掌握手术适应证,该项微创技术值得临床推广。
[Abstract]:Objective to compare the clinical effects of transforaminal interbody fusion (Mini-TLIF) and open transforaminal interbody fusion (Open-TLIF) in the treatment of lumbar spondylolisthesis. Methods A retrospective analysis of 40 cases of single segment lumbar spondylolisthesis with Quadrant posterior minimally invasive open system assisted transforaminal interbody fusion was performed in 20 cases as minimally invasive group, and open lumbar posterior approach through interforaminal fusion in 20 cases as open group. The data of perioperative period were collected, including incision length, intraoperative bleeding, drainage, operation time and time to get out of bed. VAS and ODI scores were recorded before, 2 weeks, 2 months, 1 year and 2 years after operation. To compare the curative effect between minimally invasive group and open group. Results in the minimally invasive group, the incision length, the amount of bleeding and the time of getting out of bed after operation were better than those in the open group (P0.01), but the operation time of the minimally invasive group was longer than that of the open group (P0.05). The scores of VASG ODI in the two groups showed a downward trend after operation, and there were significant differences between the postoperative scores and the preoperative scores (P0.01). In the minimally invasive group, the decrease of VASN ODI score was greater than that in the open group (P0.01). At 2 weeks after operation, the score of VASO ODI in the minimally invasive group was better than that in the open group (P 0.01). Conclusion Mast Quadrant minimally invasive transforaminal interbody fusion has the advantages of small incision, less blood loss during and after operation, early time to get out of bed after operation, and short term clinical effect, as compared with open lumbar intervertebral fusion through interforaminal approach. As long as the indication of operation is strictly grasped, the minimally invasive technique is worth popularizing.
【作者单位】：广西壮族自治区人民医院骨科;
【基金】：广西医疗卫生重点科研课题(编号:重2011106)
【分类号】：R687.3

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