CAJ | 학술논문

目的：探讨微创通道下经椎间孔减压联合椎体间融合辅助经皮椎弓根螺钉治疗腰椎退变性疾病的疗效。方法腰椎退变性疾病患者52例，行微创通道下经椎间孔减压联合椎体间融合辅助经皮椎弓根螺钉固定术治疗，观察手术时间、术中出血量、视觉模拟评分法（VAS）和Oswestry功能障碍指数（ODI）评分、并发症、椎间融合情况及疗效。结果52例患者均获得随访，平均随访14个月。手术时间为120～240 min，平均180．1 min；术中出血量100～350 ml，平均110．5 ml；发生并发症4例（7．7％）。末次随访时植骨融合48例（92．3％），可能融合3例（5．8％），未融合1例（1．9％）。 VAS评分及ODI评分均随时间延长而降低（P＜0．05）。末次随访时采用改良Macnab标准评价疗效，优37例（71．2％），良14例（26．9％），可1例（1．9％），优良率为98．1％（51/52）。结论微创通道下减压融合联合经皮椎弓根螺钉内固定治疗腰椎退变性疾病可获得较好疗效。
목적：탐토미창통도하경추간공감압연합추체간융합보조경피추궁근라정치료요추퇴변성질병적료효。방법요추퇴변성질병환자52례，행미창통도하경추간공감압연합추체간융합보조경피추궁근라정고정술치료，관찰수술시간、술중출혈량、시각모의평분법（VAS）화Oswestry공능장애지수（ODI）평분、병발증、추간융합정황급료효。결과52례환자균획득수방，평균수방14개월。수술시간위120～240 min，평균180．1 min；술중출혈량100～350 ml，평균110．5 ml；발생병발증4례（7．7％）。말차수방시식골융합48례（92．3％），가능융합3례（5．8％），미융합1례（1．9％）。 VAS평분급ODI평분균수시간연장이강저（P＜0．05）。말차수방시채용개량Macnab표준평개료효，우37례（71．2％），량14례（26．9％），가1례（1．9％），우량솔위98．1％（51/52）。결론미창통도하감압융합연합경피추궁근라정내고정치료요추퇴변성질병가획득교호료효。
Objective To explore the efficacy of minimally invasive decompression and transforaminal lumbar interbody fusion ( TLIF ) combined with percutaneous pedicle screw fixation for the treatment of lumbar degenerative diseases.Methods Fifty-two patients with lumbar degenerative diseases were treated with minimally invasive decompression and TLIF combined with percutaneous pedicle screw fixation.The operation time,intraoperative blood loss,the scores of visual analogue scale(VAS) and Oswestry disability index(ODI),complications,intervertebral fusion and efficacy were observed . Results Fifty-two cases were all followed up and the mean time was 14 months.The operation time ranged from 120 to 240 minutes,the average was 180.1 minutes.The intraoperative blood loss ranged from 100 to 350 ml,the mean was 110.5 ml. There were 4 cases(7.7%) who had complications.In the final follow-up,48 cases(92.3%) achieved bony fusion,3 cases (5.8%) achieved possible bony fusion and one case (1.9%) did not achieve bony fusion.The scores of VAS and ODI decreased with the increasing time(P<0.05).The clinical outcomes were determined by using a modified Macnab criteria in the final follow-up, which revealed that 37 cases(71.2%) had excellent results,14(26.9%) good results and 1(1.9%) fair results.The excellent and good rate was 98.1%(51/52).Conclusion Minimally invasive decompression and TLIF combined with percutaneous pedicle screw fixation can provide good efficacy in treating lumbar degenerative diseases .