摘要
目的 探讨Quadrant通道下微创经椎间孔椎间融合术治疗高位腰椎间盘突出症的临床疗效.方法 2008年2月至2011年6月,在Quadrant通道下经椎间孔入路“L”型截骨刀经椎间孔截骨,“齿槽状”绞刀处理椎间盘及终板,椎间植骨融合内固定术治疗高位腰椎间盘突出症患21例,采用视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）评估患者术前、术后1周、术后3个月及末次随访时患者疼痛及功能恢复情况,并对椎间植骨融合情况进行随访.结果 21例患者均顺利完成,手术时间2.5～3h,平均2.8h;平均出血量430 （350～ 500） ml,术中无硬膜损伤.术前VAS、ODI分别为（7.3±0.8）、（43.7±12.9）分,术后1周、3个月、末次随访时VAS、ODI分别为（2.1±0.9）、（22.5±10.4）、（1.3±0.6）、（16.2±8.5）、（0.6±0.5）、（11.3±7.2）分,术后1周与术前比较,术后3个月较术后1周,末次随访较术后3个月比较差异均有统计学意义（P＜0.05）,植骨融合率为100％.结论 Quadrant通道微创TLIF技术,应用自行设计的“L”型截骨刀及“齿槽状”绞刀治疗高位腰椎间盘突出症取得了满意的临床效果.
Objective To evaluate the treatment outcomes of mini-invasive transforaminal lumbar interbody fusion by Quadrant system for upper lumbar disc herniation.Methods Between February 2008 and June 2011,21 patients with upper lumbar disc herniation underwent mini-invasive transforaminal lumbar interbody fusion under Quadrant system at our institution.The relevant patient data included visual analogue scale （VAS） and Oswestry disability index （ODI） scores before and after operation 1 week,3 months and last follow-up.And all data were collected retrospectively.Results No operation-related complications occurred.The mean operative duration was 2.8 （2.5-3） hours.The average blood loss volume was 430 （350-500） ml.Preoperative VAS was 7.3 ± 0.8 and 2.1 ± 0.9,1.3 ± 0.6,0.6 ± 0.5 after operation 1 week,3 months and last follow-up respectively.Statistically significant differences were demonstrated between each group.Preoperative ODI was 43.7 ± 12.9 and 22.5 ± 10.4,16.2 ± 8.5,11.3 ± 7.2 after operation 1 week,3 months and last follow up.Significant differences existed in preoperative and postoperative ODI scores respectively.Conclusion Mini-invasive transforaminal lumbar interbody fusion using Quadrant system and special osteotome is safe and efficacious for upper lumbar disc herniation.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第37期2929-2933,共5页
National Medical Journal of China
关键词
椎间盘移位
腰椎
脊柱融合术
外科器械
Intervertebral disk displacement
Lumbar vertebrae
Spinal fusion
Surgical instruments
