摘要
目的：探讨腰椎侧路微创椎间融合术（mini-LIF）治疗伴椎间隙塌陷腰椎间盘突出症的可行性和临床疗效。方法回顾性分析2008年4月至2013年8月广州军区广州总医院采用mini-LIF手术治疗15例伴椎间隙塌陷腰椎间盘突出症患者的临床资料。其中男10例，女5例；年龄34～78岁，平均年龄52岁。手术节段：L1/22例、L2/34例、L3/46例、L4/53例。手术在XLIF/DLIF配套的工作通道下完成，采用椎弓根螺钉进行侧前方内固定。结果患者均顺利完成手术，手术时间60 min（40～100 min），术中出血量20 mL（10～40 mL），切口长度35 mm（30～40 mm），术后下地时间24 h（12～48 h），住院时间5 d（3～7 d）。术后切口均一期愈合，5例患者出现术侧腹股沟区和大腿内侧麻痛不适症状，对症处理后消失，无其他手术相关并发症。15例患者均获得随访，随访时间12～64个月，平均随访时间35个月。术后3 d，3、6、12个月腰痛、腿痛视觉模拟量表（VAS）及Oswestry功能障碍指数（ODI）评分均较术前显著改善（P＜0.05）；术后6个月X线片、CT检查示内固定物位置良好，椎间植骨均获融合。结论对于伴椎间隙塌陷的腰椎间盘突出症患者，mini-LIF是一种可行、有效的微创手术方法，具有手术时间短、创伤小、出血少、恢复快等优点。
Objective To explore the feasibility and clinical efficacy of minimally invasive lateral interbody fusion （mini-LIF） for the treatment of lumar disc herniation （LDH） with intervertebral space collapse. Methods Clinical data of 15 patients of LDH with intervertebral space collapse treated in Guangzhou General Hospital of＆amp;nbsp;Guangzhou Military Command from April 2008 to August 2013 were retrospectively analyzed, in which there were 10 male and 5 female, with the average age of 52 years old （34-78 years old）. The operative segments involved L1/2 in 2 patients, L2/3 in 4, L3/4 in 6 and L4/5 in 3 patients. All of patients underwent pedicle screw fixation anteriorlaterally under the working channel of XLIF/DLIF system. Results All patients underwent the opeations smoothly. The average operative time was 60 min （40-100 min）, the estimate blood loss was 20 mL （10-40） mL, incision length was 35 mm （30-40 mm）, weight-bearing time was 24 h （12-48 h）, and the hospital stay was 5 d （3-7 d）. Surgical incisions were healed within normal period of time in all patients. There remained mild pain, numbness, discomfort of inguinal area and inner thigh at surgical side in 5 patients, which vanished after symptomatic treatment. No other operation-related complications occured. All patients were followed up for 12-64 months, with the average time of 35 months. Compared with preoperative ones, visual analogue scale and Oswestry disability index scores at 3 days and 3, 6 and 12 months after the surgery were improved significantly （P 〈0.05）; X-ray and CT examination at six months follow-up showed internal fixators at good position, and all patients got solid fusion. Conclusion For LDH patients with intervertebral space collapse, mini-LIF is feasible and effective method, with the advantages of short operative time, less injury and estimate blood loss, as well as rapid rehabilitation.
出处
《中国骨科临床与基础研究杂志》
2014年第5期266-272,共7页
Chinese Orthopaedic Journal of Clinical and Basic Research
基金
广东省广学研基金(2012B091000161)
关键词
腰椎
椎间盘移位
椎间隙塌陷
外科手术
微创性
侧路椎间融合
Lumbar vertebrae
Intervertebral disk displacement
Intervertebral space collapse
Surgical procedures,minimally invasive
Lateral interbody fusion
