摘要
目的探讨Quadrant通道下经椎间孔腰椎体间融合(TLIF)结合经皮椎弓根螺钉内固定治疗退变性腰椎滑脱的疗效。方法采用Quadrant通道下TLIF结合经皮椎弓根螺钉内固定治疗21例退变性腰椎滑脱患者。记录手术时间、术中出血量、总住院时间、切口愈合情况、椎体复位情况、手术前后腰痛VAS评分及椎间融合情况,采用Nakai标准评定临床疗效。结果手术时间150~220 min,术中出血量50~250 ml,总住院时间8~18 d。20例切口甲级愈合,1例出现切口皮缘干性坏死,经换药处理后愈合。21例均获得随访,时间9~24个月。患者滑脱均复位,无植骨不融合。末次随访时患者腰痛VAS评分为1.5分±2.1分,与术前6.5分±2.9分比较差异有统计学意义(P<0.05)。末次随访时按Nakai标准评定疗效:优17例,良3例,可1例,优良率为20/21。结论 Quadrant通道下TLIF结合经皮椎弓根螺钉内固定治疗退变性腰椎滑脱创伤小,疗效满意。
Objective To investigate the effect of percutaneous pedicle screw fixation via MAST Quadrant retractor transflraminal lumbar interbody fusion （TLIF） in the treatment of degenerative lumbar spondylolisthesis. Methods Twenty-one patients with degenerative lumbar spondylolisthesis were treated with percutaneous pedicle screw fixation via MAST Quadrant retractor TLIF. The tllowing data were recorded and used to evaluate the clinical effect： the op- eration time, intraoperative blood loss, length of lotal hospital stay, wound healing, postoperative verlebral reduction, preoperative and postoperative VAS of low back pain and intervertebral fusion rate. Nakai standard was used to evalu- ate the clinical effect. Results The operation time was 150 -220 min, intraoperative blood loss volume was 50 250 ml, and the length of hospital stay was 8 - 18 d. Twenty cases got the first stage healing, 1 case had dry skin necrosis in the incision, and was healed after dressing change. The 21 patients were followed up for 9 - 24 months, the patients spondylolisthesis were all reduced, all cases got bony fusion. In the last follow-up, the patients＇ VAS of low back pain decreased from 6.5 - 2. 9 preoperatively to 1.5 ±2. 1, the difference was statistically significant （ P 〈 0.05 ）. According to Nakai evaluation criteria, the results of the last follow-up visit were listed ： 17 cases were excel- lent, 3 cases good, 1 fair, the excellent and good rate was 20/21. Conclusions MAST Quadrant retractor TLIF combined with percutaneous pedicle screw fixation in the treatment of degenerative lumbar spondylolisthesishas has less trauma and satisfactory curative effect.
出处
《临床骨科杂志》
2018年第1期14-16,共3页
Journal of Clinical Orthopaedics
关键词
QUADRANT通道
经椎间孔腰椎体间融合
经皮椎弓根螺钉内固定
退变性腰椎滑脱
MAST Quadrant retractor
transforamina
lumbar interbody fusion
percutaneous pediele screw internal fix-ation
degenerative lumbar spondylolisthesis
