摘要
目的探讨采用MAST Quadrant通道下微创技术行腰椎融合术的方法及疗效。方法对符合行腰椎后路椎间融合术手术指征的45例患者随机分为微创组(MAST Quadrant通道下微创腰椎融合术23例)和开放组(传统技术行后路腰椎融合术22例)。比较两组手术时间、术中出血量、住院时间、术后服止痛药时间、ODI评分、JOA评分等方面的差异。结果手术时间:微创组150～190(167.25±12.72)min,开放组140～180(163.41±13.49)min(P=0.032);术中出血量:微创组210～320(250.50±37.90)ml,开放组500～900(634.09±59.41)ml(P=0.000);术后住院时间:微创组4～9(5.3±1.57)d,开放组10～16(12.91±2.58)d(P=0.000);术后服止痛药时间:微创组3～14(9.05±6.82)d,开放组8～21(15.41±4.90)d(P=0.000)。45例术后切口均Ⅰ期愈合。患者均获得随访,时间6～20(14.5±4.90)个月。末次随访时ODI评分:微创组5～18(11.25±3.35)分,开放组9～19(13.95±2.97)分(P=0.000);JOA评分:微创组20～29(25.85±2.64)分,开放组17～29(23.59±3.46)分(P=0.011)。术后6个月X线片示均已达椎体间骨性融合,未见椎弓根螺钉松动、断裂或移位。结论经MAST Quadrant通道下行腰椎融合术是一种安全、有效的微创方法。
Objective To evaluate the effect of posterior lumbar interbody fusion via MAST Quadrant retractor.Methods 45 cases of posterior lumbar interbody fusion were divided randomly into two groups:MAST and PLIF.The group MAST of 23 patients underwent posterior lumbar interbody fusion via MAST Quadrant,and the other group PLIF of 22 patients underwent regular posterior lumbar interbody fusion.The factors considered included the operative time,the volume of blood loss,the hospitalization time,postooperative pain time served,the Japanese orthopedic association low back pain score(JOA),Oswestry Disability Index(ODI).Results The operative time:The group MAST was 150～190(167.25±12.72)min,the group PLIF was 140～180(163.41±13.49)min(P=0.032).The amount of blood loss: the group MAST was 210～320(250.50±37.90)ml,the group PLIF was 500～900(634.09±59.41)ml(P=0.000).The hospitalization time: the group MAST was 4～9(5.3±1.57)d,the group PLIF was 10～16(12.91±2.58) d(P=0.000).Postoperative pain time served: the group MAST was 3～14(9.05±6.82) d,the group PLIF was 8～21(15.41±4.90)d(P=0.000).All incisions healed by first intention.All patients were followed up for(14.5±4.90) months on average(from 6 to 20 months).The ODI score of MAST were 5～18(11.25±3.35)at the last follow-up,and the ODI score of PLIF were 9～19(13.95±2.97)at the last follow-up(P=0.000).The JOA score of MAST were 20～29(25.85±2.64) at the last follow-up,The JOA scores of PLIF were17～29(23.59±3.46)at the last follow-up(P=0.011).The two sets of MAST and PLIF JOA and ODI score showed significant difference(P<0.05).The X-ray films showed that lumbar interbody fusion was achieved in all the patients.No loosening,breakage,and displacement of pedicle screw fixation was observed.Conclusions PLIF via MAST Quadrant retractor is a safe,effective,and minimally invasive surgical technique.
出处
《临床骨科杂志》
2011年第6期605-608,共4页
Journal of Clinical Orthopaedics
基金
福建省卫生厅青年科研课题(编号:2009-2-94)
