摘要
目的比较分析采用Quadrant通道与传统开放单侧后路腰椎椎体间融合术治疗退行性腰椎疾病的临床效果及优缺点。方法 2008年1月~2011年6月,87例退行性腰椎疾病患者采用随机分组行单侧后路腰椎椎体间融合术,其中40例采用Quadrant通道微创手术治疗,47例采用传统开放手术治疗作为对照。比较两组手术时间、术中失血量及术后住院时间等,采用VAS疼痛评分、ODI功能障碍评分和改良MacNab分级进行疗效评定。结果全部病例随访12~52个月,平均26.7个月。两组手术时间、出血量、术后住院时间等差异有统计学意义。两组术后VAS疼痛评分比较差异有统计学意义（P〈0.05）;两组ODI功能障碍评分和改良MacNab分级评定差异无统计学意义。结论 Quadrant通道下单侧后路腰椎椎体间融合术治疗退行性腰椎疾病具有术中出血量少、创伤小、术后恢复快、疗效确切等优点,是临床上可行的实用的一种脊柱微创术式,与传统开放式手术比较疗效相近,为退行性腰椎疾病的外科治疗提供又一选择,但由于提供的操作空间有限,手术视野小,所以病例选择及手术操作熟练程度显得尤其重要。
【Objective】 The clinical efficacy,the advantages and disadvantages of treating degenerative lumbar disease through adopting Quadrant channel and traditional open unilateral posterior lumbar interbody fusion are compared for analysis.【Method】 87 cases of degenerative lumbar disease patients from January of 2008 to June of 2011 were randomly grouped for accepting unilateral posterior lumbar interbody fusion,wherein 40 case adopted Quadrant minimally invasive surgery,and 47 cases adopted traditional open surgery treatment as control.The operative time,intraoperative blood loss,postoperative hospital stay and the like of the two groups were compared;efficacy was assessed through using the VAS pain score,ODI dysfunction score,and modified MacNab classification.【Results】 All patients were followed up for 12～52 months with an average of 26.7 months.The operation time,bleeding volume,postoperative hospitalization time and the like of the two groups were significantly different.Postoperative VAS pain scores were compared between the two groups P 0.05 with significant difference;the comparison of the ODI dysfunction score and modified MacNab classification had no statistically significant difference.【Conclusions】 Unilateral posterior lumbar interbody fusion under Quadrant channel for treatment of degenerative lumbar spinal disorders has the advantages of less blood loss,small trauma,fast postoperative recovery,clear curative effect and the like,and it belongs to clinically feasible and practical spinal minimally invasive surgical procedures.It has similar efficacy compared with traditional open surgery,and provides another choice for the surgical treatment of degenerative lumbar disease,but patient selection and surgical operation proficiency are particularly important due to small operating space provided by the working channel.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2012年第26期77-82,共6页
China Journal of Modern Medicine
关键词
腰椎
脊柱疾病
脊柱融合术
微创性
内固定器
lumbar
spinal disease
spinal fusion
minimally invasive
internal fixation device
