摘要
目的:评价Quadrant通道下经上关节突椎间孔外入路融合术联合经皮椎弓根螺钉固定术治疗Ⅰ、Ⅱ度退变性腰椎滑脱症的早期临床疗效。方法:回顾性分析2018年7月至2019年7月采用该术式治疗的32例Ⅰ、Ⅱ度退变性腰椎滑脱患者的病历资料,记录手术时间、术中失血量、术后引流量、术后下地时间,比较患者手术前后腰痛、腿痛视觉模拟评分(VAS)、Oswestry功能障碍指数(The Oswestry Disability Index,ODI)评分、椎体滑脱程度(Degree of Spondylolisthesis,DS)、腰椎前凸角(Lumbar Lordosis,LL)、椎间隙高度(Disc Height,DH)、椎间孔高度(Intervertebral Foramen Height,FH)、椎管矢状径(Sagittal Diameter of Spinal Canal,SDS)、椎管横截面积(Cross-Sectional Area of Spinal Canal,CAC),并进行统计学分析。结果:本组患者手术时间(80.24±10.28)min,术中出血量(120.32±10.39)mL,术后引流量(50.21±9.32)mL,术后下地时间(3.35±1.97)d,术后1例出现出口根刺激症状。临床疗效上,术后各时间点的腰痛VAS、腿痛VAS、ODI评分较术前明显改善,差异有统计学意义(P<0.01)。影像学评价上,术后3 d、术后末次随访的椎体滑脱程度、腰椎前凸角、椎间隙高度、椎间孔高度、椎管矢状径、椎管横截面积较术前明显改善,差异有统计学意义(P<0.01)。随访期间,32例患者内固定无移位、椎间融合理想。结论:Quadrant通道下经上关节突椎间孔外入路融合术联合经皮椎弓根螺钉固定治疗退变性腰椎滑脱症早期临床疗效明确,创伤小,失血少,结构破坏少,术后恢复快,并且影像学指标明显改善。
Objective:To evaluate the early clinical efficacy of extra-superior articular process-foraminal lumbar interbody fusion combined with percutaneous pedicle screw fixation in the treatment of degenerative lumbar spondylolisthesis of degree Ⅰ and Ⅱ under Quadrant channel.Methods: The clinical data of 32 patients with degenerative lumbar spondylolisthesis treated by this operation from July 2018 to July 2019 were retrospectively analyzed. The operation time, intraoperative blood loss, postoperative drainage volume, ambulation time were recorded. Before and after operation, the visual analogue scale(VAS), the Oswestry disability index(ODI) score, degree of spondylolisthesis(DS),lumbar lordosis(LL), disc height(DH), intervertebral foramen height(FH), sagittal diameter of spinal canal(SDS), and cross-sectional area of spinal canal(CAC) were compared and analyzed. Results:The operation time was(80.24±10.28) min, the intraoperative blood loss was(120.32±10.39) mL, the postoperative drainage volume was(50.21±9.32) mL, ambulation time was(3.35±1.97) d. In terms of clinical efficacy, VAS, ODI scores of low back pain, leg pain at each time point after operation were significantly improved compared with those before operation(P<0.01). In terms of imaging evaluation, the DS,LL,DH,FH,SDS,CAC were significantly improved 3 d after operation, and the differences were statistically significant(P<0.01). During the follow-up period, 32 patients had no displacement of internal fixation and ideal interbody fusion.Conclusion:The treatment of degenerative lumbar spondylolisthesis through extra-superior articular process-foraminal lumbar interbody fusion combined with percutaneous pedicle screw fixation under Quadrant channel has clear early clinical efficacy, less trauma, less blood loss, less structural damage, fast postoperative recovery, and obvious improvement of imaging indicators.
作者
饶耀剑
李俊杰
梁舒涵
崔家伟
朱博
杨磊
韩志
刘燕
RAO Yaojian;LI Junjie;LIANG Shuhan;CUI Jiawei;ZHU Bo;YANG Lei;HAN Zhi;LIU Yan(Luoyang Orthopedic Hospital of Henan Province,luoyang 471002,Henan China;Hubei 672 Orthopaedics Hospital of Integrated Chinese&Western Medicine,Wuhan 430079,China)
出处
《中国中医骨伤科杂志》
CAS
2021年第7期60-64,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
武汉市卫生计生委科研计划资助项目(WZ20Q05)。
关键词
腰椎融合术
间接减压
腰椎滑脱症
extra-superior articular process-foraminal lumbar interbody fusion
indirect decompression
lumbar spondylolisthesis
