摘要
目的评估并比较机器人辅助短节段经皮固定联合单侧局限性椎板切除病灶清除与前路手术方法治疗老年单节段腰椎结核患者的临床疗效。方法回顾性收集97例单节段腰椎结核老年患者,其中46例患者接受机器人辅助短节段经皮固定联合单侧局限性椎板切除术,51例接受前路手术治疗。比较机器人辅助组和前路组的手术时间、术中失血量、术后引流量、住院时间、下地活动时间、并发症、输血率、白蛋白输注率、住院费用、腰痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)和实验室检查结果。结果97例患者在平均19个月的随访中均符合骨性融合标准。机器人辅助组的术中失血量明显低于前路组,住院时间和下地活动时间明显短于前路组(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。术后7天和1个月,机器人辅助组的VAS评分明显低于前路组(P<0.001);术后7天、1个月和3个月,机器人辅助组的ODI评分均明显优于前路组(P<0.05);机器人辅助组在术后24小时和术后1个月的血红蛋白和白蛋白明显高于前路组(P<0.05)。结论机器人辅助短节段经皮固定联合单侧局限性椎板切除病灶清创,可作为治疗单节段腰椎结核老年患者的一种有效而安全的手术。
Objective To evaluate and compare the clinical efficacy between robot assisted short-segment percutaneous fixation combined with unilateral localized laminectomy and anterior surgery in the treatment of elderly patients with single segment lumbar tuberculosis.Methods Ninety-seven older patients with single segment lumbar tuberculosis were retrospectively collected.Among these patients,46 were treated with robot-assisted short-segment percutaneous fixation combined with unilateral localized laminectomy and 51 were treated with the anterior surgical approach.The operative time,blood loss,postoperative drainage,hospital stay,ambulation time,complications,blood transfusion rate,albumin infusion rate,hospital cost,visual analogue scale(VAS),Oswestry Disability Index(ODI)and laboratory results were compared between the two groups.Results All 97 patients met criteria for bony fusion during an average follow-up of 19 months.The intraoperative blood loss of the robot-assisted group was significantly less than that of the anterior group,and the hospitalization time and ambulation time were significantly shorter than those of the anterior group(P<0.05). There were no significant differences in complication rates between the two groups(P>0.05).After 7 days and one month of surgery,VAS score in the robot-assisted group was significantly lower than that in the anterior group(P<0.001).The ODI score of the robot-assisted group was significantly better than that of the anterior group after 7 days,1 month and 3 months of operation(P<0.05).Hemoglobin and albumin in the robot-assisted group were significantly higher than those in the anterior group after 24 hours and one month of surgery(P<0.05).Conclusions Robot-assisted short-segment percutaneous fixation combined with unilateral localized laminectomy is an effective and safe treatment for older patients with single segment lumbar tuberculosis.
作者
尹之玮
唐六一
胡豇
俞阳
林书
YIN Zhi-wei;TANG Liu-yi;HU Jiang;YU Yang;LIN Shu(Southwest Medical University,Luzhou 646000,China;Department of Orthopedics,Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital(Affiliated Hospital of University of Electronic Science and Technology of China),Chengdu 610072,China)
出处
《实用医院临床杂志》
2024年第3期34-38,共5页
Practical Journal of Clinical Medicine
基金
四川省科技厅科技支撑项目(编号:2022YFS0018,2022YFS0019,2022YFS0100)
国家重点研发计划(编号:2022YFC2407506)。
关键词
机器人
经皮
椎板切除
腰椎
结核
Robot
Percutaneous
Laminectomy
Lumbar
Tuberculosis
