CAJ | 학술논문

目的：探讨应用经椎间孔椎体间融合（ TLIF）技术治疗胸腰段间盘突出症的可行性。方法回顾2009年12月至2013年5月天津医院脊柱外科15例采用后路椎板切除减压＋TLIF技术治疗的单节段胸腰段间盘突出症患者资料。男9例，女6例；年龄平均41．2（25～72）岁。所有患者按照日本骨科协会（ JOA）29分法以及Frankel神经功能分级标准进行临床疗效评估。结果手术时间平均140（115～180）min；术中出血量平均320（100～500） ml。所有患者全程随访，随访时间平均19（3～44）个月。随访期内全部患者的症状均有不同程度的恢复和改善，无复发病例。末次随访按照JOA评分标准，改善率优9例，良4例，可2例；优良13例，有效15例。按照Frankel神经功能分级标准，术前：A级2例，B级2例，C级4例，D级7例；术后：B级1例，C级1例，D级4例，E级9例。结论应用TLIF技术联合后路椎板切除减压治疗胸腰段间盘突出症具有解剖简单，术野清晰，操作简便、安全，减压彻底、有效，固定融合可靠等优点。
목적：탐토응용경추간공추체간융합（ TLIF）기술치료흉요단간반돌출증적가행성。방법회고2009년12월지2013년5월천진의원척주외과15례채용후로추판절제감압＋TLIF기술치료적단절단흉요단간반돌출증환자자료。남9례，녀6례；년령평균41．2（25～72）세。소유환자안조일본골과협회（ JOA）29분법이급Frankel신경공능분급표준진행림상료효평고。결과수술시간평균140（115～180）min；술중출혈량평균320（100～500） ml。소유환자전정수방，수방시간평균19（3～44）개월。수방기내전부환자적증상균유불동정도적회복화개선，무복발병례。말차수방안조JOA평분표준，개선솔우9례，량4례，가2례；우량13례，유효15례。안조Frankel신경공능분급표준，술전：A급2례，B급2례，C급4례，D급7례；술후：B급1례，C급1례，D급4례，E급9례。결론응용TLIF기술연합후로추판절제감압치료흉요단간반돌출증구유해부간단，술야청석，조작간편、안전，감압철저、유효，고정융합가고등우점。
Objective To explore the feasibility , safety and efficacy of treating thoracolumbar disc herniation with transforaminal lumbar intervertebral fusion ( TLIF) .Methods From December 2009 to May 2013, 15 consecutive patients with one-level thoracolumbar disc herniation underwent TLIF .There were 9 males and 6 females with an average age of 41.2 (25-72) years.According to the Japanese Orthopedic Association ( JOA ) criteria and Frankel grading system , it was evaluated for the clinical effects of all patients.Results The average operative duration was 140 (115-180) min and mean blood loss volume 329 (100-500) ml.The symptoms improved all greatly over an average follow-up period of 19 (3-44) months.According to the JOA criteria system, the outcomes were excellent (n=9, 60%), good (n=4, 26.6%) and fair (n=2, 13.4%).Based on the Frankel grading system , 2 cases were classified as A (n=2), 2 as B (n=2), 4 as C (n=4) and 7 as D (n=7) preoperatively versus B (n=1), C (n=1), D ( n=4 ) and E ( n =9 ) postoperatively .Conclusion The combined approach of TLIF plus posterior laminectomy is anatomically simple, visually distinct, relatively safe, reliable and efficacious in treatment of thoracolumbar disc herniation .