中国骨伤
中國骨傷
중국골상
CHINA JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
2014年
6期
500-503
,共4页
减压术,外科%脊柱融合术%腰椎
減壓術,外科%脊柱融閤術%腰椎
감압술,외과%척주융합술%요추
Decompression,surgical%Spinal fusion%Lumbar vertebrae
目的：观察椎管潜行减压单侧改良经椎间孔腰椎间融合术（transforaminal lumbar interbody fusion，TLIF）手术治疗腰椎退行性疾病的临床疗效。方法：自2009年8月至2011年12月，采用椎管潜行减压单侧改良TLIF手术治疗腰椎退行性疾病患者28例，其中男16例，女12例；年龄46～71岁，平均61岁；病程6个月～6年。腰椎管狭窄症20例，腰椎间盘突出症8例。潜行减压范围：单节段24例，双节段4例。左侧15例，右侧13例。采用JOA下腰痛评分系统（29分）评价手术前后临床症状、体征及括约肌功能；并采用视觉模拟评分（VAS）评估手术前后腰腿痛情况。结果：28例患者获随访，时间6～28个月，平均14个月。术后JOA、VAS评分（17．9±2．2、2．8±0．7）与术前（8．5±1．7、8．6±1．2）比较有明显改善（P＜0．05）。28例患者椎间均达到骨性融合。结论：采用椎管潜行减压单侧改良TLIF手术治疗单侧根性症状的腰椎管狭窄症、腰椎间盘突出症，具有创伤小、疗效确切的优点；能明显节省医疗费用，值得临床研究推广。
目的：觀察椎管潛行減壓單側改良經椎間孔腰椎間融閤術（transforaminal lumbar interbody fusion，TLIF）手術治療腰椎退行性疾病的臨床療效。方法：自2009年8月至2011年12月，採用椎管潛行減壓單側改良TLIF手術治療腰椎退行性疾病患者28例，其中男16例，女12例；年齡46～71歲，平均61歲；病程6箇月～6年。腰椎管狹窄癥20例，腰椎間盤突齣癥8例。潛行減壓範圍：單節段24例，雙節段4例。左側15例，右側13例。採用JOA下腰痛評分繫統（29分）評價手術前後臨床癥狀、體徵及括約肌功能；併採用視覺模擬評分（VAS）評估手術前後腰腿痛情況。結果：28例患者穫隨訪，時間6～28箇月，平均14箇月。術後JOA、VAS評分（17．9±2．2、2．8±0．7）與術前（8．5±1．7、8．6±1．2）比較有明顯改善（P＜0．05）。28例患者椎間均達到骨性融閤。結論：採用椎管潛行減壓單側改良TLIF手術治療單側根性癥狀的腰椎管狹窄癥、腰椎間盤突齣癥，具有創傷小、療效確切的優點；能明顯節省醫療費用，值得臨床研究推廣。
목적：관찰추관잠행감압단측개량경추간공요추간융합술（transforaminal lumbar interbody fusion，TLIF）수술치료요추퇴행성질병적림상료효。방법：자2009년8월지2011년12월，채용추관잠행감압단측개량TLIF수술치료요추퇴행성질병환자28례，기중남16례，녀12례；년령46～71세，평균61세；병정6개월～6년。요추관협착증20례，요추간반돌출증8례。잠행감압범위：단절단24례，쌍절단4례。좌측15례，우측13례。채용JOA하요통평분계통（29분）평개수술전후림상증상、체정급괄약기공능；병채용시각모의평분（VAS）평고수술전후요퇴통정황。결과：28례환자획수방，시간6～28개월，평균14개월。술후JOA、VAS평분（17．9±2．2、2．8±0．7）여술전（8．5±1．7、8．6±1．2）비교유명현개선（P＜0．05）。28례환자추간균체도골성융합。결론：채용추관잠행감압단측개량TLIF수술치료단측근성증상적요추관협착증、요추간반돌출증，구유창상소、료효학절적우점；능명현절성의료비용，치득림상연구추엄。
Objective:To observe preliminary efficacy of decompressive unilateral improved transforaminal lumbar inter-body fusion(TLIF) for the treatment of lumbar degenerative diseases. Methods:From August 2009 to December 2011,28 pa-tients with lumbar degenerative diseases were treated by decompressive unilateral improved TLIF ,including 16 males and 12 females with an average of 61 (aged 46 to 71) years old,the courses of disease ranged from 6 months to 6 years. Among them , 20 cases suffered from lumbar spinal stenosis ,8 cases were lumbar disc herniation. Decompressive range included single seg-ment in 24 cases,and double segments in 4 cases;15 cases were performed operation on the left side,13 cases on the right side. JOA lower back pain scoring system (29 points) were applied for evaluate preoperative and postoperative symptoms, physical signs and sphincteral functions;Visual analogue scale (VAS) were used to evaluate preoperative and postoperative low back pain. Results:All patients were followed up 6 to 28 (mean 14) months. Postoperative JOA score and VAS score were 17.9±2.2,2.8±0.7 respectively,and preoperative JOA score and VAS score were 8.5±1.7,8.6±1.2,respectively. There were significant meaning in JOA and VAS scores before and after operation (P<0.05). Twenty-eight patients were all obtained inter-vertebral synostosis. Conclusion:Decompressive unilateral improved TLIF for treatment of unilateral radicular lumbar spinal stenosis and lumbar disc herniation,which has advantages of minimally invasive,curative effects,decrease medical costs,is worthy spreading in clinical.
