CAJ | 학술논문

目的：比较经Quadrant通道椎弓根螺钉内固定与传统后路椎弓根固定治疗腰椎退行性疾病的疗效。方法回顾分析126例腰椎退行性疾病患者的临床资料，按手术方式分为两组，其中Quadrant微创组62例和传统开放组64例。对比分析两组患者手术情况、症状改善情况及影像学资料。结果两组患者术后均获得了显著的疗效，出院时微创组生活质量改善率优于开放组（P＜0．05），术后1个月及末次随访时微创组生活质量改善率与开放组比较，差异无统计学意义（P＞0．05），而微创组手术切口长度、术中出血量、术后引流量、术后下床活动时间、术后住院时间均明显短于开放组（P＜0．05），末次随访日本矫形外科协会（JOA）评分优良率比较，差异无统计学意义（ P＞0．05）。结论 Quadrant微创技术具有操作损伤少、手术出血少、术后恢复快等优点，且手术操作不复杂，临床疗效确切，其治疗价值得临床推广。
목적：비교경Quadrant통도추궁근라정내고정여전통후로추궁근고정치료요추퇴행성질병적료효。방법회고분석126례요추퇴행성질병환자적림상자료，안수술방식분위량조，기중Quadrant미창조62례화전통개방조64례。대비분석량조환자수술정황、증상개선정황급영상학자료。결과량조환자술후균획득료현저적료효，출원시미창조생활질량개선솔우우개방조（P＜0．05），술후1개월급말차수방시미창조생활질량개선솔여개방조비교，차이무통계학의의（P＞0．05），이미창조수술절구장도、술중출혈량、술후인류량、술후하상활동시간、술후주원시간균명현단우개방조（P＜0．05），말차수방일본교형외과협회（JOA）평분우량솔비교，차이무통계학의의（ P＞0．05）。결론 Quadrant미창기술구유조작손상소、수술출혈소、술후회복쾌등우점，차수술조작불복잡，림상료효학절，기치료개치득림상추엄。
Objective To evaluate the effects of Quadrant minimally invasive treatment system versus traditional technique plus posterior approach applied to pedicle screw fixation on the treatment of lumbar degenerative disease . Methods The data of 126 patients suffered from lumbar degenerative disease were analyzed retrospectively .According to the operation method,126 cases were divided into two groups:62 in the minimally invasive group who were treated with Quadrant minimally invasive treatment system,64 in the open group who were treated with traditional operation.The operation status,the improvement of symptoms and radiography results of two groups were compared .Results The patients of two groups all achieved the remarkable curative effects after surgery .The improvement rate of quality of life of minimally invasive group was better than that of open group at discharge (P<0.05).But there was no significant difference in the improvement rate of quality of life at one month after operation or in the last follow-up between two groups (P>0.05).The surgical incision length,intraoperative blood loss,postoperative drainage flow,ambulation time,postoperative hospitalization time of Quadrant group were significantly less than those of open group (P<0.05).The excellent rate of JOA score showed no significant difference between two groups in the last follow-up(P>0.05).Conclusion Quadrant minimally invasive system applied to treating lumbar degenerative disease has the advantages of less tissue damage ,less bleeding and quicker postoperative recovery .The operation is simple and the clinical effect is definite .It is worthy of clinical application .