CAJ | 학술논문

目的：探讨小切口短节段经椎间孔腰椎椎间融合（TLIF）技术治疗腰椎退变性侧凸（LDS）的早期疗效。方法2011年1月至2012年12月广州医科大学附属第一医院采用小切口短节段TLIF治疗26例LDS患者。按视觉模拟量表（VAS）评分标准评估患者术后疼痛缓解情况，比较手术前后冠状面Cobb角、腰椎前凸角的差异，评估末次随访VAS评分改善率、Cobb角矫正率及腰椎前凸角改善率，计算末次随访椎间融合率。结果随访时间6～17个月（平均12.1个月）。术后6个月和末次随访时，VAS评分分别为（3.0±0.8）分和（3.0±1.1）分，较术前的（8.0±0.9）分明显降低（P＜0.05）；末次随访VAS评分改善率为62.5%。末次随访Cobb角较术前有明显改善[（7.7±2.8）° vs（17.3±5.5）°，P ＜0.05]，矫正率为55.5%；末次随访腰椎前凸角明显优于术前[（36.8±4.5）° vs（18.1±4.6）°，P＜0.05]，改善率为103.3%。末次随访植骨融合率达100%。结论小切口短节段TLIF治疗LDS早期疗效确切，可有效缓解患者腰腿痛症状，纠正侧凸并改善腰椎前凸，椎间融合率高。
목적：탐토소절구단절단경추간공요추추간융합（TLIF）기술치료요추퇴변성측철（LDS）적조기료효。방법2011년1월지2012년12월엄주의과대학부속제일의원채용소절구단절단TLIF치료26례LDS환자。안시각모의량표（VAS）평분표준평고환자술후동통완해정황，비교수술전후관상면Cobb각、요추전철각적차이，평고말차수방VAS평분개선솔、Cobb각교정솔급요추전철각개선솔，계산말차수방추간융합솔。결과수방시간6～17개월（평균12.1개월）。술후6개월화말차수방시，VAS평분분별위（3.0±0.8）분화（3.0±1.1）분，교술전적（8.0±0.9）분명현강저（P＜0.05）；말차수방VAS평분개선솔위62.5%。말차수방Cobb각교술전유명현개선[（7.7±2.8）° vs（17.3±5.5）°，P ＜0.05]，교정솔위55.5%；말차수방요추전철각명현우우술전[（36.8±4.5）° vs（18.1±4.6）°，P＜0.05]，개선솔위103.3%。말차수방식골융합솔체100%。결론소절구단절단TLIF치료LDS조기료효학절，가유효완해환자요퇴통증상，규정측철병개선요추전철，추간융합솔고。
Objective To evaluate early therapeutic effect of short segment transforaminal lumbar interbody fusion (TLIF) through minimal access for treatment of lumbar degenerative scoliosis (LDS). Methods From January 2011 to December 2012, 26 patients with LDS were treated by short segment TLIF with minimal access in the First Affiliated Hospital of Guangzhou Medical University. Postoperative pain relief was evaluated according to visual analogue scale (VAS) scoring, Preoperative and postoperative angles of lumbar lordosis and scoliosis were compared, the improvement rates of VAS score, Cobb's angle and lumar lordosis angle were evaluated, and the intervertebral fusion rates were also calculated. Results Mean follow-up duration was 12.1 months (6-17 months). Mean preoperative VAS score was (8.0 ± 0.9), while (3.0 ± 0.8), (3.0 ± 1.1) at 6 months after the operation and at the last follow-up respectively, the difference between preoperative and postoperative VAS scores had statistical significance (P <0.05). Cobb's angle of lumbar scoliosis was corrected from preoperative (17.3 ± 5.5)° to (7.7 ± 2.8)° at the last follow-up, with the correction rate of 55.5%; The angle of lumbar lordosis was corrected from preoperative (18.1 ± 4.6)° to (36.8 ± 4.5)° at the last follow-up, with the improvement rate of 103.3%. The intervertebral fusion rate was 100% at the latest follow-up. Conclusion Short segment TLIF through minimal access for treatment of LDS could obtain reliable short-term clinical outcomes with satisfactory pain relief, good correction of Cobb's angle and lumbar lordosis angle, as well as high intervertebral fusion rate.