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术中即时三维导航微创经椎间孔椎体间融合术治疗腰椎退行性疾病 被引量:13

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摘要 目的:观察术中即时三维导航微创经椎间孔椎体间融合术治疗腰椎退行性疾病的临床疗效及安全性.方法:2010年2月至2012年8月,采用术中即时三维导航微创经椎间孔椎体间融合术治疗腰椎退行性疾病患者40例,男27例,女13例.年龄26 ~55岁,中位数43岁.其中腰椎间盘突出症11例,腰椎间盘突出症术后复发5例,椎间盘源性下腰痛10例,腰椎不稳8例,腰椎滑脱6例.均为腰椎单节段病变.L3~L42例、L4~L523例、L5~S115例.病程2~28个月,中位数16个月.观察记录手术时间和术中出血量,采用Oswestry功能障碍指数问卷表评价患者腰椎功能改善情况,采用JOA下腰痛评分系统评定疗效.结果:手术时间110~ 185 min,中位数145 min.术中出血量210 ~320 mL,中位数265 mL.所有患者均获随访,随访时间6~17个月,中位数12个月.所有患者切口均愈合.手术节段椎体均于术后9个月内获得骨性融合.均无神经损伤、椎间隙感染、硬脊膜损伤和脑脊液漏等并发症.6例腰椎滑脱患者中,2例术后残留Ⅰ度滑脱,其余均恢复正常.术后12个月复查时,JOA评分由术前(8.5±4.1)分升至(23.9±2.5)分;Oswestry功能障碍指数评分由术前(26.8±5.0)分降至(7.6±2.7)分.根据JOA下腰痛评分系统标准评定疗效,优21例、良15例、可4例.结论:术中即时三维导航微创经椎间孔椎体间融合术治疗腰椎退行性疾病,具有手术时间短、术中出血量少、植骨融合率高、并发症少、疗效好等优点,有助于促进患者腰椎功能恢复,值得临床推广应用.
出处 《中医正骨》 2014年第3期46-48,共3页 The Journal of Traditional Chinese Orthopedics and Traumatology
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