CAJ | 학술논문

目的探讨椎间盘镜辅助X-Tube下腰椎后路椎体间融合术(posterior lumbar interbody fusion,PLIF)和经椎间孔腰椎椎体间融合术(transforaminal lumbar interbody fusion,TLIF)治疗退变性椎间盘疾病的临床疗效.方法 2007年11月至2008年4月,采用椎间盘镜辅助X-Tube下TLIF和PLIF 治疗退变性椎间盘疾病32例:PLIF 13例,TLIF 19例.单节段腰椎间盘突出症伴相应节段腰椎不稳定21例,腰椎滑脱症11例(Ⅰ度6例,Ⅱ度5例).病变节段:L3-4 2例,L4-5 18例,L5S1 12例.年龄38～72岁,平均51.2岁;男19例,女13例.术后进行定期随访和影像学检查,并进行Oswestry功能障碍指数评定以评价术后康复情况.结果手术时间90～180 min,平均120 min;手术出血量100～400 ml,平均190ml.切口均为甲级愈合,未见切口及椎管、椎间隙感染、内固定失败等并发症发生.所以患者均获随访,随访时间13～41个月,平均21个月.Oswestry功能障碍指数由术前40.1％±4.1％下降到术后3个月的9.5％±3.7％.疗效评价:优19例,良10例,可3例;优良率为90.6％.骨融合均取得成功.结论椎间盘镜辅助X-Tube下TLIF和PLIF治疗退变性椎间盘疾病具有切口小,创伤小,术后恢复快等优点.
목적 탐토추간반경보조X-Tube하요추후로추체간융합술(posterior lumbar interbody fusion,PLIF)화경추간공요추추체간융합술(transforaminal lumbar interbody fusion,TLIF)치료퇴변성추간반질병적림상료효.방법 2007년11월지2008년4월,채용추간반경보조X-Tube하TLIF화PLIF 치료퇴변성추간반질병32례:PLIF 13례,TLIF 19례.단절단요추간반돌출증반상응절단요추불은정21례,요추활탈증11례(Ⅰ도6례,Ⅱ도5례).병변절단:L3-4 2례,L4-5 18례,L5S1 12례.년령38～72세,평균51.2세;남19례,녀13례.술후진행정기수방화영상학검사,병진행Oswestry공능장애지수평정이평개술후강복정황.결과 수술시간90～180 min,평균120 min;수술출혈량100～400 ml,평균190ml.절구균위갑급유합,미견절구급추관、추간극감염、내고정실패등병발증발생.소이환자균획수방,수방시간13～41개월,평균21개월.Oswestry공능장애지수유술전40.1％±4.1％하강도술후3개월적9.5％±3.7％.료효평개:우19례,량10례,가3례;우량솔위90.6％.골융합균취득성공.결론 추간반경보조X-Tube하TLIF화PLIF치료퇴변성추간반질병구유절구소,창상소,술후회복쾌등우점.
Objective To evaluate the clinical effects of transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion(PLIF) using microendoscopic discectomy under X-Tube system in treatment of lumbar degenerative disc diseases.Methods From December 2007 to April 2008,32 patients with low back disorders were treated by microendoscopic discectomy TLIF or PLIF under X-Tube system,including 19 cases in TLIF and 13 in PLIF.Etiologies including lumbar disc herniation combined with segmental instability in 21 cases,and spondylolisthesis in 11 cases.All patients were under regular postoperative follow-up and radiological examination.The clinical functional outcomes were evaluated according to Oswestry disability questionnaire.Results The mean operation time was 120 min (range,90-180),and the average blood loss was 190 ml (range,100-400).There were no complications,such as infection and internal fixation failure.Bony fusion was achieved in all patients.The follow-up was from 14 months to 41 months with 21 months in the average.The average 0swestry scores decreased from preoperative 40.1％±4.1％ to 9.5％±3.7％ three months after the operation.The outcomes of this operation were rated as excellent.Conclusion Microendoscopic discectomy TLIF or PLIF under X-Tube system in treatment of lumbar degenerative disc diseases has the characteristics of less blood loss,tissue trauma and quick recovery.