摘要
背景:小切口极外侧入路椎间融合和微创经椎间孔入路椎间融合因手术技术容易掌握,严重并发症少,临床应用广泛。但对于同时符合2种手术适应证的腰椎退行性疾病患者,如何选择手术方式还需进一步探讨。目的:比较小切口极外侧椎间融合和微创经椎间孔椎间融合治疗腰椎退行性疾病的临床疗效。方法;回顾性分析2016年6月至2017年12月收治的单节段腰椎退行性疾病患者76例,分为小切口极外侧椎间融合组和微创经椎间孔入路椎间融合组,比较2组患者的手术时间、术中出血量、术后目测类比评分、Oswestry功能障碍指数、日本骨科协会评分、并发症、术后腰椎融合节段前凸角、椎间隙高度及椎间位移情况。结果与结论:①小切口极外侧椎间融合组的手术时间及术中出血量均优于微创经椎间孔入路椎间融合组(P<0.05);②小切口极外侧椎间融合组的并发症发生率(19%)高于微创经椎间孔入路椎间融合组(10%),差异有显著性意义(P<0.05);③2组术后的日本骨科协会评分、目测类比评分、Oswestry功能障碍指数、椎间隙高度、融合节段前凸角差异无显著性意义(P>0.05);④末次随访时小切口极外侧椎间融合节段前凸角大于微创经椎间孔入路椎间融合组,融合节段椎间隙高度高于微创经椎间孔入路椎间融合组,差异均有显著性意义(P<0.05),2组椎间位移差异无显著性意义(P>0.05);⑤提示小切口极外侧椎间融合和微创经椎间孔椎间融合均可有效治疗腰椎退行性疾病,小切口极外侧椎间融合在手术时间、术中出血量及维持腰椎融合节段前凸角和椎间隙高度方面有优势,但并发症较多。
BACKGROUND:Small-incision extreme lateral interbody fusion and minimally invasive transforamen interbody fusion are widely used to treat patients with lumbar degenerative diseases because of easy operation technology and less serious complications.However,for patients with lumbar degenerative diseases who meet the indications of both surgical methods,how to choose surgical methods needs further study.OBJECTIVE:To compare the clinical outcome between small-incision extreme lateral interbody fusion and minimally invasive transforamen interbody fusion in patients with lumbar degenerative diseases.METHODS:Seventy-six patients with single-segment lumbar degenerative diseases treated from June 2016 to December 2017 were retrospectively analyzed.The patients were divided into small-incision extreme lateral interbody fusion group and minimally invasive transforamen interbody fusion group.Operation time,intraoperative blood loss,postoperative visual analogue scale,Oswestry dysfunction index,Japanese Orthopedic Association score,complications,anterior convex angle of lumbar fusion segment,intervertebral height and intervertebral displacement were compared between the two groups.RESULTS AND CONCLUSION:(1)Operation time and intraoperative blood loss were better in the small-incision extreme lateral interbody fusion group than in the minimally invasive transforamen interbody fusion group(P<0.05).(2)The incidence of complications was significantly higher in the small-incision extreme lateral interbody fusion group(19%)than in the minimally invasive transforamen interbody fusion group(10%)(P<0.05).(3)There were no significant differences in visual analogue scale,Oswestry dysfunction index,Japanese Orthopedic Association score,intervertebral height,and anterior convex angle of fusion segment after surgery between the two groups(P>0.05).(4)At the last follow-up,the anterior convex angle of fusion segment was larger in the small-incision extreme lateral interbody fusion group than in the minimally invasive transforamen interbody fusion group.The intervertebral height of fusion segment was higher in the small-incision extreme lateral interbody fusion group than in the minimally invasive transforamen interbody fusion group(P<0.05).There was no significant difference in intervertebral displacement between the two groups(P>0.05).(5)Both small-incision extreme lateral interbody fusion and minimally invasive transforamen interbody fusion can treat lumbar degenerative diseases effectively.Small-incision extreme lateral interbody fusion is superior to minimally invasive transforamen interbody fusion in terms of operation time,intraoperative blood loss and maintaining the anterior convex angle and intervertebral height of lumbar fusion segment,but incidence of complications is higher.
作者
王诗成
潘磊
李捷
薛厚军
陈伟雄
雷宇
Wang Shicheng;Pan Lei;Li Jie;Xue Houjun;Chen Weixiong;Lei Yu(Department of Spine and Joint Surgery,Foshan Sanshui District People's Hospital,Foshan 528100,Guangdong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第30期4829-4834,共6页
Chinese Journal of Tissue Engineering Research
基金
佛山市科技局医学攻关项目(2016AB001425),项目负责人:王诗成
佛山市科技局医学攻关项目(2017AB001295),项目负责人:李捷。
关键词
骨
影像
腰椎退变
椎间融合
微创
椎间隙
bone
image
lumbar degeneration
interbody fusion
minimally invasive
intervertebral space
