摘要
目的:探讨经皮椎弓根螺钉复位固定、内窥镜(METRx)下椎管减压、椎间盘切除、椎间植骨融合治疗腰椎疾患的效果。方法:2004年1月～2006年2月共收治腰椎间盘突出和/或腰椎滑脱患者19例,男12例,女7例;年龄32～69岁,平均47.9岁。均采用经皮椎弓根螺钉复位固定、后路内窥镜手术系统行椎管减压、椎间盘切除、椎间植骨融合术治疗,随访观察治疗效果。结果:手术时间140～330min,平均190min;出血量50～300ml,平均110ml;术后住院时间7～18d,平均10.5d。3例出现并发症,发生率为16.3%。手术切口均一期愈合。18例患者获得6～32个月(平均13.5个月)随访,16例患者椎间骨性融合,2例骨性椎间融合尚不完全。根据Nakai分级,优11例(61.1%),良5例(27.8%),可2例(11.1%)。结论:经皮椎弓根螺钉复位固定、内窥镜下椎管减压、椎间盘切除、椎间植骨融合术具有手术切口小、腰骶肌肉剥离范围小、出血少、术后恢复快等优点,但其手术时间相对较长,手术操作难度较高,需要特殊设备和工具,术中医患所受辐射量较大。
Objective：To evaluate the effect of surgical treatment of percutaneous pedicle screw fixation,discectomy,spinal canal decompression and autografi implantation using METRx operation system in patients with lumbar disc herniation and segmental instability.Method：19 patients including 12 male and 7 female were treated in our department.The age ranged from 32 to 69 years （mean,47.9 years）.The site and extent of disc herniation were affirmed by CT and MRI.And lumbar segmental instability was assessed by flexion-extension film.All patients underwent diseectomy,spinal canal decompression,cage implantation and Sextant lumbar fixation under the METRx operation system.Result：The average operation time was 190min （range,140-330min）, the average blood loss was 110ml （range,50-300ml） and the average hospitalization time was 10.5 days （range,7-18 days ）.Complications were in 3 cases （16.3%）.One-stage incision healing were achieved in all patients.18 cases were followed-up 6-32 months （average 13.5 months）,16 cases got bony fusion,and poor bony fusion in 2 cases.According to the Nakai criteria,the clinical effect was excellent in 11 cases （61.1%）, good in 5 cases（27.8%） and fair in 2 cases（11.1%）.Conclusion：Despite the surgical procedure has some disadvantages,it stills has shown predominant benefits：small incision,less stripping of paraspinal muscles,minimal blood loss and rapid postoperative recovery.All these make it a valuable alternative to conventional surgical procedures.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第5期333-336,共4页
Chinese Journal of Spine and Spinal Cord
