摘要
目的探讨内镜下减压融合经皮微创椎弓根螺钉内固定治疗腰椎Ⅰ、Ⅱ度滑脱的早期疗效。方法回顾性分析2018年1月至2018年6月该院实行内镜下减压、复位、椎间融合、椎弓根螺钉内固定手术治疗的16例腰椎Ⅰ度滑脱、7例Ⅱ度滑脱患者的临床资料为微创组;另回顾性分析同期行腰椎后路椎间融合(PLIF)椎弓根螺钉内固定术治疗的18例腰椎Ⅰ度滑脱、12例腰椎Ⅱ度滑脱患者的临床资料为对照组;术后对两组患者随访3~9个月,比较两组患者手术时间,术中出血量,术前、术后1个月、术后3个月视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)。结果两组患者一般资料比较差异无统计学意义(P>0.05);微创组平均手术时间长于对照组(P<0.05);微创组术中出血量少于对照组(P<0.05);两组患者术后1个月、术后3个月VAS评分、ODI与术前比较均有明显改善(P<0.05),两组间术前、术后1个月及术后3个月VAS评分、ODI比较差异无统计学意义(P>0.05)。结论与传统后路开放手术相比,内镜下减压椎间融合经皮椎弓根钉内固定治疗腰椎Ⅰ、Ⅱ度滑脱的早期疗效显著,虽然手术时间长,但出血少、创伤小,患者恢复快且更容易被患者所接受。
【Objective】To investigate the early efficacy of endoscopic decompression,interbody fusion and percutaneous minimally invasive pedicle screw fixation for lumbar spondylolisthesis.【Methods】A retrospective analysis was made of 23 patients with lumbar spondylolisthesis treated by endoscopic decompression and fusion and percutaneous minimally invasive pedicle screw internal fixation from January 2018 to June 2018.Sixteen patients with gradeⅠand 7 patients with gradeⅡspondylolisthesis underwent posterior decompression,reduction and interbody fusion.Thirty patients with grade I and II spondylolisthesis were randomly selected as control group and followed up for 3-9 months.The average follow-up time was 4.8 months and 5.1 months.The operation time,bleeding volume,VAS and ODI of lumbar spine were compared between the two groups before operation,1 month after operation and 3 months after operation.【Results】There were no significant differences in gender,age,and weight between the two groups(P>0.05).The average operation time of minimally invasive group was(131.01±27.33)min,which was longer than that of the control group[(98.57±23.76)min],and the difference was statistically significant(P<0.05).The amount of bleeding in the minimally invasive group was(68.04±12.25)ml,which was less than that in the control group[(489.01±142.47)ml],and the difference was statistically significant(P<0.05).One month and 3 months after operation,VAS and ODI were significantly improved when compared with pre-operation(P<0.05).There was no significant difference between the two groups(P>0.05).【Conclusion】Compared with traditional posterior open surgery,endoscopic decompression and interbody fusion and percutaneous pedicle screw fixation for lumbar spondylolisthesis of degreeⅠandⅡhave a significant early effect.Although the operation takes a long time,it has less bleeding and less trauma.
作者
王向前
李军
郭广铭
郭洋洋
宋中学
刁文博
刁文杰
WANG Xiangqian;LI Jun;GUO Guangming;GUO Yangyang;SONG Zhongxue;DIAO Wenbo;DIAO Wenjie(Department of Orthopaedics,Zhoukou Union Osteological Hospital,Zhoukou,Henan 466000,China)
出处
《中国医学工程》
2019年第12期58-60,共3页
China Medical Engineering
关键词
内镜
减压融合
椎弓根螺钉内固定
腰椎Ⅰ、Ⅱ度滑脱
改善情况
endoscopy
decompression and fusion
pedicle screw internal fixation
lumbar spondylolisthesisⅠand Ⅱ
improvement
