摘要
目的比较Quadrant通道下微创经椎间孔椎体间融合(MIS-TLIF)与开放经椎间孔椎体间融合(TLIF)治疗腰椎退行性疾病的临床效果。方法回顾性分析2016年4月至2017年4月于新乡医学院第一附属医院行手术治疗的46例腰椎退行性疾病患者的临床资料,其中20例患者采用MIS-TLIF术式(MIS-TLIF组),26例患者采用开放TLIF术式(开放TLIF组),比较2组患者术中失血量、手术时间、切口长度、术后引流量、术后下床时间、住院时间、住院费用、术后并发症及术后1、3、6、12个月疼痛视觉模拟(VAS)评分和Oswestry功能障碍指数(ODI)。结果 MISTLIF组患者术中失血量、切口长度、术后引流量、住院费用均少于开放TLIF组(P<0.05),术后下床时间、住院时间短于开放TLIF组(P<0.05);2组患者手术时间比较差异无统计学意义(P>0.05)。术后1、3个月,MIS-TLIF组患者疼痛VAS评分和ODI均低于开放TLIF组(P<0.05);术后6、12个月,2组患者疼痛VAS评分和ODI比较差异无统计学意义(P>0.05)。2组患者均无硬脊膜及神经损伤、内固定断裂等并发症发生;开放TLIF组患者术后发生伤口愈合延迟2例,切口感染1例,术后并发症发生率为11.5%(3/26);MIS-TLIF组患者无术后并发症发生,术后并发症发生率为0.0%(0/20);2组患者术后并发症发生率比较差异无统计学意义(χ2=2.471,P>0.05)。结论 Quadrant通道下MIS-TLIF治疗腰椎退行性疾病具有术中失血少、切口小、术后引流量少等优势,可作为治疗腰椎退行性疾病的首选手术方法。
Objective To compare the clinical effect between minimally invasive transforaminal lumbar interbody fusion( MIS-TLIF) via Quadrant minimally invasive system and open transforaminal lumbar interboday fusion( TLIF) in treating lumbar degeneration disease. Methods Clinical data of 46 patients in the First Affiliated Hospital of Xinxiang Medical University from April 2016 to April 2017 with lumbar degenerative diseases who were given operation treatment were analyzed retrospectively. Twenty patients underwent MIS-TLIF via Quadrant minimally invasive system( MIS-TLIF group) and twenty-six patients underwent open-TLIF( open TLIF group). The blood loss,operative time,length of incision,volume of drainage after operation,time of ambulation,hospitalization time,hospitalization cost,postoperative complications,visual pain simulation( VAS) score and Oswestry disability index( ODI) at 1,3,6 and 12 months after operation were compared between the two groups. Results The blood loss,length of incision,volume of drainage after operation,time of ambulation,hospitalization time,hospitalization cost in the MIS-TLIF group were less than those in the open TLIF group( P < 0. 05); there was no significant difference in operative time between the two groups( P > 0. 05). The VAS score and ODI of the MIS-TLIF group were lower than those of the open TLIF group at 1 and 3 months after surgery( P < 0. 05); there was no significant difference in the VAS score and ODI between the two groups at 6 and 12 months after surgery( P > 0. 05). There was no complication such as dural and nerve injury and internal fixation rupture in the two groups. In the open TLIF group,postoperative wound healing was delayed in two cases,postoperative incision infection occurred in one cases,the incidence of postoperative complication was 11. 5%( 3/26). In the MIS-TLIF group no postoperative complication occurred,the incidence of postoperative complication was 0. 0%( 0/20); the incidence of postoperative complications was not statistically significant between the two groups( χ2= 2. 471,P > 0. 05). Conclusion MIS-TLIF via Quadrant minimally invasive system has the advantages of less blood loss,incision and volume of drainage after operation in treating lumbar degenerative disease,and it can be used as the first choice for the treatment of lumbar degenerative disease.
出处
《新乡医学院学报》
CAS
2018年第3期212-215,共4页
Journal of Xinxiang Medical University
关键词
腰椎退行性疾病
微创
经椎间孔椎体间融合
lumbar degeneration disease
minimally invasive
transforaminal lumbar interboday fusion
作者简介
闫骏宏（1988-）,男,河南信阳人,硕士研究生在读,研究方向：脊柱与关节疾病.;通信作者：徐海斌（1963-）,男,河南新乡人,主任医师,教授,研究方向：脊柱与关节疾病;E-mail：drxhb＠163.com.
