中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2011年
12期
1067-1070
,共4页
毛克亚%王岩%肖嵩华%张永刚%刘保卫%张西峰%崔庚%张雪松%李鹏%毛克政
毛剋亞%王巖%肖嵩華%張永剛%劉保衛%張西峰%崔庚%張雪鬆%李鵬%毛剋政
모극아%왕암%초숭화%장영강%류보위%장서봉%최경%장설송%리붕%모극정
脊柱融合术%外科手术,微创性%单侧切口%混合内固定
脊柱融閤術%外科手術,微創性%單側切口%混閤內固定
척주융합술%외과수술,미창성%단측절구%혼합내고정
Spinal fusion%Surgical procedures,minimally invasive%Unilateral incision%Hybrid fixation
目的 探讨单侧切口微创经椎间孔腰椎体间融合术(MIS-TLIF)采用椎弓根螺钉结合对侧经椎板关节突螺钉混合内固定的可行性和安全性.方法 2010年1月至6月18例单节段腰椎退变性疾病患者,采用单侧切口METRxTM X-tube进行MIS-TLIF手术,同侧置入椎弓根螺钉后进行加压固定,同一切口向对侧置入经椎板关节突螺钉,进行围手术期指标观察、影像学和术后疗效评价.结果 所有患者均顺利完成手术,未出现并发症.平均手术时间(107±19)min,术中出血量(62±21)ml,术后平均下床活动时间(21±5)h.经椎板关节突螺钉平均长度(52± 2) mm.术后X线和CT显示螺钉均穿过关节突关节,术后和随访期间腰痛和腿痛视觉模拟评分与Oswestry功能障碍指数评分与术前相比均明显改善(F =42.221 ～259.833,P＜0.01).结论 单侧切口MIS-TLIF可完成椎弓根螺钉结合经椎板关节突螺钉的双侧混合内固定,具有创伤小、恢复快、缩短手术时间、节省内固定费用等优点.
目的 探討單側切口微創經椎間孔腰椎體間融閤術(MIS-TLIF)採用椎弓根螺釘結閤對側經椎闆關節突螺釘混閤內固定的可行性和安全性.方法 2010年1月至6月18例單節段腰椎退變性疾病患者,採用單側切口METRxTM X-tube進行MIS-TLIF手術,同側置入椎弓根螺釘後進行加壓固定,同一切口嚮對側置入經椎闆關節突螺釘,進行圍手術期指標觀察、影像學和術後療效評價.結果 所有患者均順利完成手術,未齣現併髮癥.平均手術時間(107±19)min,術中齣血量(62±21)ml,術後平均下床活動時間(21±5)h.經椎闆關節突螺釘平均長度(52± 2) mm.術後X線和CT顯示螺釘均穿過關節突關節,術後和隨訪期間腰痛和腿痛視覺模擬評分與Oswestry功能障礙指數評分與術前相比均明顯改善(F =42.221 ～259.833,P＜0.01).結論 單側切口MIS-TLIF可完成椎弓根螺釘結閤經椎闆關節突螺釘的雙側混閤內固定,具有創傷小、恢複快、縮短手術時間、節省內固定費用等優點.
목적 탐토단측절구미창경추간공요추체간융합술(MIS-TLIF)채용추궁근라정결합대측경추판관절돌라정혼합내고정적가행성화안전성.방법 2010년1월지6월18례단절단요추퇴변성질병환자,채용단측절구METRxTM X-tube진행MIS-TLIF수술,동측치입추궁근라정후진행가압고정,동일절구향대측치입경추판관절돌라정,진행위수술기지표관찰、영상학화술후료효평개.결과 소유환자균순리완성수술,미출현병발증.평균수술시간(107±19)min,술중출혈량(62±21)ml,술후평균하상활동시간(21±5)h.경추판관절돌라정평균장도(52± 2) mm.술후X선화CT현시라정균천과관절돌관절,술후화수방기간요통화퇴통시각모의평분여Oswestry공능장애지수평분여술전상비균명현개선(F =42.221 ～259.833,P＜0.01).결론 단측절구MIS-TLIF가완성추궁근라정결합경추판관절돌라정적쌍측혼합내고정,구유창상소、회복쾌、축단수술시간、절성내고정비용등우점.
Objective To investigate the feasibility and safety of unilateral incision hybrid fixation using pedicle screws and a translaminar screw in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).Methods From January to June 2010,18 patients with single-level lumbar disc disease were treated with MIS-TLIF under METRxTM X-tube.After decompression and fixation using unilateral pedicle screws,a translaminar screw was inserted from the same incision to the other side.The results of perioperative parameters,radiographic images and clinical outcomes were assessed.Results All patients underwent MIS-TLIF were accomplished unilateral hybrid fixation without any neural complication.The average operative time was (107 ± 19)min,the average operative blood loss was(62 ± 21 )ml,and the average postoperative ambulation time was (21 ± 5 ) h.The average length of translaminar facets screw was (52 ± 2)mm,and the postoperative images showed all screws penetrate through facets joint.During the follow-up the visual analogue scale and Oswestry disability index scores were significant improved compared with preoperative ( F =42.221-259.833,P ＜ 0.01 ).Conclusions Bilateral hybrid fixation could be completed through unilateral incision by pedicle screws and a translaminar screw in MIS-TLIF,and the advantage including less invasion,quickly recovery,short operative time,and saving fixation cost.
