摘要
目的比较分析机器人联合显微镜辅助椎间孔腰椎椎体间融合术(MIS-TLIF)与常规MIS-TLIF治疗腰椎管狭窄症的临床疗效。方法经医院伦理委员会批准后,选择2020年11月至2022年6月68例腰椎管狭窄症患者开展调查,根据采用治疗方案的差异进行命名,常规MIS-TLIF治疗组即常规组(n=32),机器人联合显微镜辅助MIS-TLIF治疗组即机器人显微镜组(n=36),将2组腰腿疼痛、ODI指数及生活质量进行比较分析。结果术前2组疼痛评分、ODI指数差异无统计学意义(P>0.05);术后3个月机器人显微镜组腰腿部疼痛评分、ODI指数均低于常规组(P<0.05);术后6个月、12个月2组疼痛、ODI指数评分差异无统计学意义(P>0.05)。2组手术出血量与手术时间差异无统计学意义(P>0.05);观察组的置钉准确率高于对照组,术后神经损伤并发症率低于对照组(P<0.05);机器人显微镜组治疗后的生活质量评分高于常规组(P<0.05)。结论在机器人联合显微镜的辅助下可以获得更清晰的手术视野,避免术中损伤神经减少了相关并发症,同时还增加了置钉的准确率,与常规MIS-TLIF相比,机器人联合显微镜辅助MIS-TLIF不会增加术中出血量,也不会延长手术时间,术后疼痛与功能障碍问题能够得到快速改善,有助于生活质量的提升。
Objective To compare the clinical efficacy of robotic combined with microscope-assisted minimally invasive transforaminal lumbar interbody function(MIS-TLIF)versus conventional MIS-TLIF on the treatment of lumbar spinal stenosis.Methods After the approval of the ethics committee of the hospital,68 patients with lumbar spinal stenosis treated from November 2020 to June 2022 were recruited and divided into conventional group(n=32)and robotic combined with microscope-assisted treatment group(n=36).Conventional MIS-TLIF and robotic combined with microscope-assisted MIS-TLIF were performed in two groups,respectively.The lumbago and leg pain,Oswestry Disability Index(ODI)and quality of life of the two groups were compared and analyzed.Results There were no significant differences in the preoperative pain score and ODI between groups(P>0.05).Three months after operation,the pain score and ODI in the robotic combined with microscope-assisted treatment group were significantly lower than those in the conventional group(P<0.05).There were no significant differences in the pain score and ODI between groups at 6 and 12 months postoperatively(P>0.05).There were no significant differences in the bleeding amount and surgery time between groups(P>0.05).Significantly higher accuracy of nail placement and lower incidence of postoperative nerve injury were detected in the robotic combined with microscope-assisted treatment group than those in the conventional group(both P<0.05).The quality of life score was significantly higher in the robotic combined with microscope-assisted treatment group than that in the conventional group(P<0.05).Conclusion Robotic combined with microscope-assisted MIS-TLIF provides a clearer surgical field,prevents intraoperative nerve injury,reduces postoperative complications and enhance the accuracy of nail placement.Compared with conventional MIS-TLIF,robotic combined with microscope-assisted MIS-TLIF does not increase the intraoperative bleeding amount and prolongs surgery time.It rapidly alleviates postoperative pain and dysfunction,which contributes to enhance the quality of life.
作者
刘军
李晓
刘丽君
孟飞
尹晓鹏
王智
宋文轩
LIU Jun;LI Xiao;LIU Lijun(Jingxing Hospital,Hebei,Shijiazhuang 050300,China)
出处
《河北医药》
CAS
2023年第12期1862-1865,共4页
Hebei Medical Journal
基金
石家庄市科学技术研究与发展计划(编号:201460813)。
关键词
腰椎管狭窄症
机器人联合显微镜
椎间孔腰椎椎体间融合术(MIS-TLIF)
疼痛
lumbar spinal stenosis
robotic combined with microscope-assisted surgery
minimally invasive transforaminal lumbar interbody function(MIS-TLIF)
pain
