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微创改良TLIF治疗腰椎退变性疾病87例临床疗效观察

Clinical efficacy of treatment of 87 patients with lumbar degenerative disease by minimally invasive modified TLIF
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摘要 目的探讨通过Quadrant系统改良经椎间孔椎间融合术(改良TLIF)治疗腰椎退变性疾病的临床疗效。方法对收治的87例腰椎退变性疾病患者均采用后路中央两旁多裂肌间隙入路,在Quadrant可扩张通道微创系统下行改良TLIF。采用视觉模拟法(VAS)疼痛评分和日本矫形外科协会(JOA)评分评估临床疗效,并观察术前、术后各项指标及并发症情况。结果 87例患者的平均手术时间为189 min,平均手术切口长度为4.1 cm,术中平均出血量为260 ml,术后平均引流量为105 ml。并发硬脊膜破裂2例,经相应处理后治愈。所有患者随访时间平均为13.5个月,术后1周及末次随访时的腰腿痛VAS评分、JOA评分与术前相比明显降低,差异有统计学意义(P<0.05)。结论应用Quadrant可扩张通道改良TLIF治疗腰椎退变性疾病,对组织损伤轻、出血量少、术后恢复快、近期疗效肯定,是一种安全有效的微创术式。 Objective To investigate the clinical outcomes of Quadrant system modified transforaminal lum -bar interbody fusion ( modified TLIF) for treatment of lumbar degenerative disease .Methods Eigty-seven patients with lumbar degenerative disease were treated by modified TLIF assisted by Quadrant expandable tube channel mini -mally invasive system , via posterior multifidus muscle gap approach .Clinical outcomes were assessed by the VAS pain scores and JOA scores .Pre-operative and post-operative conditions and complicaions were monitored .Results In all of 87 patients, the mean operation time was 189 min, the mean incision length was 4.1 cm, the mean operative blood loss was 260 ml and the post-operative drainage was 105 ml.Two patients complicated with dural tears were cured after treatment .All patients were followed-up for 13.5 months, VAS pain scores and JOA scores of one week post-operation and last visit were significantly lower than that of pre-operation ( P〈0.05 ) .Conclusion Applying Quadrant expandable tube channel modified TLIF for treatment of lumbar degenerative disease had the advantages of less damage, bleeding and time for recovery , with acknowledged short-term outcomes.It is a safe and effective mini-mally invasive operation method .
出处 《中国临床新医学》 2014年第12期1097-1100,共4页 CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金 广西医疗卫生重点科研课题(编号:重2011106)
关键词 腰椎退变性疾病 Mast-Quadrant 微创 改良经椎间孔椎间融合术(改良TLIF) Lumbar degenerative disease Mast-Quadrant Minimally invasion Modified transtbramihal lumbar interbody fusion( modified TLIF)
作者简介 兰敏东(1988-),男,在读硕士研究生,研究方向:脊柱外科疾病诊治。E-mail:269965985@qq.com 通讯作者:韦建勋(1972-),男,研究生学历,医学硕士,硕士生导师,主任医师,研究方向:脊柱外科疾病诊治。E-mail:2630592201@qq.com
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