摘要
目的探究椎旁肌间隙(Wiltse)入路经椎间孔椎体间融合术(TLIF)治疗单节段退行性腰椎管狭窄症(DLSS)患者的效果及对血清指标的影响。方法选取2018年8月至2021年1月嵩县西关骨科医院收治的单节段DLSS患者86例作为研究对象,根据手术方式分为Wiltse入路组(n=43)、后正中入路组(n=43)。Wiltse入路组经Wiltse入路TLIF治疗,后正中入路组经后正中入路TLIF治疗。对比两组围手术期指标、手术前后血清指标[肿瘤坏死因子(TNF-α)、皮质醇(Cor)]水平、疼痛程度[视觉模拟量表(VAS)]、腰椎功能改善情况[Oswestry功能障碍指数(ODI)]及并发症发生情况。结果Wiltse入路组手术时间、住院时间均短于后正中入路组,术中出血量、引流量低于后正中入路组(P<0.05);同术前对比,术后3 d两组血清指标升高,且Wiltse入路组低于后正中入路组(P<0.05);Wiltse入路组术后3个月VAS、ODI评分均低于后正中入路组(P<0.05);观察组并发症发生率4.65%(2/43)与后正中入路组9.30%(4/43)比较,差异无统计学意义(P>0.05)。结论对单节段DLSS患者采用Wiltse入路经TLIF治疗可提高手术效果,缩短手术时间及住院时间,降低术中出血量及引流量,调节血清指标水平,缓解患者疼痛,恢复腰椎功能,促进病情改善。
Objective To explore the treatment of single-segment degenerative lumbar spinal stenosis(DLSS)by transforaminal lumbar interbody fusion(TLIF)via the Wiltse approach the therapeutic effect.Methods Eighty-six single-segment DLSS patients admitted to Songxian Xiguan Orthopedic Hospital from August 2018 to August 2020 were selected as the research objects.According to surgical methods,they were divided into Wiltse approach group(n=43)and posterior median approach group(n=43).Wiltse approach group was treated with Wiltse approach via TLIF,and the posterior median approach group was treated with posterior median approach via TLIF.Perioperative indicators,serum index levels before and after surgery[tumor necrosis factor-α(TNF-α),cortisol(Cor)],pain levels[visual analog scale(VAS)],lumbar function improvement[Oswestry dysfunction index(ODI)]and complications were compared between the two groups.Results The operative time and hospital stay in the Wiltse approach group were shorter than those in the posterior median approach group,and the blood loss and drainage volume during the operation were lower than those in the posterior median approach group(P<0.05).Compared with preoperatively,the serum levels of the two groups on the 3rd day after surgery were increased,and the Wiltse approach group was lower than the posterior median approach group(P<0.05).The Wiltse approach group’s VAS score and ODI score were lower than the posterior median approach group 3 months after surgery(P<0.05).There was no statistical difference on the total incidence of complications in the observation group was 4.65%(2/43)compared with 9.30%(4/43)in the posterior median approach group(P>0.05).Conclusion The Wiltse approach for single-segment degenerative lumbar spinal stenosis via TLIF can improve the surgical effect,shorten the operation time and hospital stay,reduce intraoperative blood loss and drainage,relieve the patient’s pain,restore lumbar spine function,and promote the improvement of the condition.
作者
杜凯
鲍朝辉
DU Kai;BAO Zhaohui(Department of Spine,Songxian Xiguan Orthopedic Hospital,Luoyang 471000,China;Department of Spine,Luoyang Osteopathic Hospital,Luoyang 471000,China)
出处
《河南医学研究》
CAS
2022年第2期282-285,共4页
Henan Medical Research
