Quadrant通道下微创腰椎后路融合术治疗单节段腰椎退行性疾病
发布时间：2018-08-08 22:02
【摘要】：目的探讨Quadrant通道下微创腰椎后路融合术治疗单节段腰椎退行性疾病的临床效果。方法回顾性分析2014年11月至2016年3月南京医科大学附属苏州医院收治的12例单节段腰椎退行性疾病的临床资料,所有患者均在Quadrant通道下经多裂肌与最长肌间隙行微创腰椎后路融合手术。其中腰椎后路椎体间融合10例、腰椎后外侧融合2例。记录手术时间、术中出血量、术后引流量、术后血红蛋白水平,以及术前、末次随访时疼痛视觉模拟量表(VAS)评分和Oswestry功能障碍指数(ODI)。结果手术时间120~260 min,平均手术时间180 min;术中出血量50~800 mL,平均术中出血量375 mL;术后引流量8~321 mL,平均引流量128mL;术后血红蛋白水平93~138 g/L,平均血红蛋白水平113 g/L。所有患者无脑脊液漏、神经根损伤、感染及术后顽固性腰背痛发生。随访5~21个月(平均16个月),术前、术后末次随访VAS评分和ODI分别为(6.4±1.0)、(2.0±0.7)分和(18±4)、(46±10)分,手术前后比较,差异均有统计学意义(P0.05)。结论 Quadrant通道下经多裂肌与最长肌间隙入路行腰椎后路融合手术治疗单节段腰椎退行性疾病具有出血少、对后方韧带破坏小、脊柱稳定性好、功能恢复快等优点,符合微创理念,值得临床推广应用。
[Abstract]:Objective to investigate the clinical effect of minimally invasive posterior lumbar fusion under Quadrant channel in the treatment of single segment lumbar degenerative diseases. Methods from November 2014 to March 2016, the clinical data of 12 cases of single segment lumbar degenerative diseases treated in Suzhou Hospital of Nanjing Medical University were retrospectively analyzed. All patients underwent minimally invasive posterior lumbar fusion through the intermuscular space of polyfissure and longissimus under Quadrant channel. Posterior lumbar interbody fusion was performed in 10 cases and posterolateral lumbar fusion in 2 cases. Time of operation, intraoperative blood loss, postoperative drainage, postoperative hemoglobin level, preoperative and last follow-up pain visual analogue scale (VAS) score and Oswestry dysfunction index (ODI).) were recorded. Results the operative time was 120 ~ 260 min, the average operation time was 180 min, the blood loss was 50 ~ 800 mL, the average intraoperative bleeding was 375 mL, the postoperative drainage flow was 8 ~ 321 mL, the average drainage flow was 128 mL, and the postoperative hemoglobin level was 93 ~ 138 g / L, with an average hemoglobin level of 113 g 路L ~ (-1). No cerebrospinal fluid leakage, nerve root injury, infection and intractable low back pain occurred in all patients. The VAS score and ODI of the last follow-up were (6.4 卤1.0), (2.0 卤0.7) and (18 卤4), (46 卤10), respectively. There were significant differences before and after operation (P0.05). Conclusion posterior lumbar fusion under Quadrant channel for the treatment of single segment lumbar degenerative diseases through the interspace of polyfissure and longissimus has the advantages of less bleeding, less damage to the posterior ligaments, good stability of the spine and quick recovery of function. It accords with the idea of minimally invasive and is worth popularizing and applying in clinic.
【作者单位】： 南京医科大学附属苏州医院骨科;
【分类号】：R687.3
本文编号：2173175
[Abstract]:Objective to investigate the clinical effect of minimally invasive posterior lumbar fusion under Quadrant channel in the treatment of single segment lumbar degenerative diseases. Methods from November 2014 to March 2016, the clinical data of 12 cases of single segment lumbar degenerative diseases treated in Suzhou Hospital of Nanjing Medical University were retrospectively analyzed. All patients underwent minimally invasive posterior lumbar fusion through the intermuscular space of polyfissure and longissimus under Quadrant channel. Posterior lumbar interbody fusion was performed in 10 cases and posterolateral lumbar fusion in 2 cases. Time of operation, intraoperative blood loss, postoperative drainage, postoperative hemoglobin level, preoperative and last follow-up pain visual analogue scale (VAS) score and Oswestry dysfunction index (ODI).) were recorded. Results the operative time was 120 ~ 260 min, the average operation time was 180 min, the blood loss was 50 ~ 800 mL, the average intraoperative bleeding was 375 mL, the postoperative drainage flow was 8 ~ 321 mL, the average drainage flow was 128 mL, and the postoperative hemoglobin level was 93 ~ 138 g / L, with an average hemoglobin level of 113 g 路L ~ (-1). No cerebrospinal fluid leakage, nerve root injury, infection and intractable low back pain occurred in all patients. The VAS score and ODI of the last follow-up were (6.4 卤1.0), (2.0 卤0.7) and (18 卤4), (46 卤10), respectively. There were significant differences before and after operation (P0.05). Conclusion posterior lumbar fusion under Quadrant channel for the treatment of single segment lumbar degenerative diseases through the interspace of polyfissure and longissimus has the advantages of less bleeding, less damage to the posterior ligaments, good stability of the spine and quick recovery of function. It accords with the idea of minimally invasive and is worth popularizing and applying in clinic.
【作者单位】： 南京医科大学附属苏州医院骨科;
【分类号】：R687.3
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