摘要
[目的]探讨应用单侧MIS-TLIF及单侧内固定治疗极外侧腰椎间盘突出症(FLLDH)的临床疗效。[方法]回顾性分析2012年6月~2016年3月,采用单侧MIS-TLIF及单侧内固定治疗的外侧腰椎间盘突出症患者37例,男18例,女19例,年龄41~76岁,平均(59.42±8.81)岁。采用疼痛视觉模拟评分(VAS评分)和功能障碍指数(ODI),以及影像学资料评价临床疗效。[结果]本组病例均顺利完成手术,手术时间70~130 min,出血量80~150 ml,术中无硬膜囊、神经根损伤。术后随访14~35个月,平均(22.13±4.82)个月。术后腰痛VAS评分、腿痛VAS评分及ODI评分,均较术前显著降低(P<0.05),且术后随时间推移上述评分进一步显著降低(P<0.05)。术后X线片随访显示内固定位置良好,术后9~15个月,平均(13.31±2.73)个月,达到椎间骨性融合。术后3例患者椎间高度有丢失,高度丢失率8.12%。无内固定松动、移位、脱落等并发症。[结论]单侧MIS-TLIF及单侧内固定治疗极外侧腰椎间盘突出症具有手术创伤小、术中出血量少、手术时间短、并发症少、恢复快等优点。
[Objective] To investigate the clinical outcomes of unilateral minimal invasive surgery-transforaminal lumbar interbody fusion(MIS-TLIF) for extreme lateral lumbar disc herniation(ELLDH). [Methods] A retrospective study was conducted on 37 patients who underwent unilateral MIS-TLIF for extreme lateral lumbar disc herniation(ELLDH) from June 2012 to March 2016, including18 males and 19 females aged 41~76 years with an average age of(59.42± 8.81) years. The visual analogue scale(VAS) for pain, the Oswestry Disability Index(ODI) and imaging data were used to evaluate the clinical outcomes.[Results] All the patients had operation performed successfully with operation time of 70~130 minutes and intraoperative blood loss of 80~150 ml, whereas without serious complications,such as dural tear and nerve injuries. The follow-up period ranged from 14 to 35 months, with an average of(22.13±4.82) months. The VAS scores of low back pain and leg pain, as well as ODI score significantly decreased postoperatively compared with those before operation(P<0.05), which further significantly decreased over time postoperatively(P<0.05). In term of radiographic assessment, all the patients had the implants placed in the proper position postoperatively, and achieved bony fusion in 9 to 15 months with an average of(13.31±2.73)months. Except of intervertebral height loss found in 3 patients with a loss rate of 8.82%, no other deteriorated radiographic phenomena, such as loosening, or displacement of the implants, were noted in anyone of them at the latest follow up. [Conclusion]This unilateral MIS-TLIF for extreme lateral lumbar disc herniation has the advantages of shortening operation time, reducing bleeding, minimizing iatrogenic trauma, reducing complications and improving recovery.
作者
于圣会
罗干
陈果
张学磊
顾祖超
YU Sheng-hui;LUO Gan;CHEN Guo;ZHANG Xue-lei;GU Zu-chao(Department of Orthopaedics,Chengdu First People’s Hospital,Chengdu 610041,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第21期1926-1930,共5页
Orthopedic Journal of China
基金
四川省卫计委普及应用项目（编号：18PJ479”）
关键词
极外侧型腰椎间盘突出症
微创通道
内固定
治疗结果
extreme lateral lumbar disc herniation
minimally invasive passage
internal fixation
clinical outcome
