CAJ | 학술논문

目的：对比小切口椎弓根钉棒椎间融合技术与传统手术方式治疗腰椎滑脱症的临床疗效。方法手术治疗腰椎滑脱症100例，其中小切口椎弓根钉棒椎间融合技术组50例，传统开放组50例。分别统计两组术中出血量、手术时间、术后引流量、住院时间，术前术后疼痛视觉VSA评分、Oswestry功能障碍指数（ODI），根据Macnab标准评定临床疗效，对各影像学数据进行对比分析。结果随访12～24个月，平均18个月，小切口组手术时间、术中出血量、术后引流量、住院时间、术后随访VAS疼痛等评分指标均比传统开放手术组具有明显优势（P＜0.01）。小切口组ODI由术前的（84.4±5.3）％减小到术后末次随访的（7.7±1.3）％；传统开放组ODI由术前的（85.9±3.9）％减小到术后末次随访的（19.2±4.9）％，两组差异有统计学意义（ P＜0.01）。结论与传统开放手术相比，小切口椎弓根钉棒椎间融合技术治疗腰椎滑脱症符合微创手术的理念，减少了椎旁组织的广泛剥离，具有切口小、住院时间短、恢复快、术后腰痛少等优点，疗效确切，操作简单，适合基层医院推广。
목적：대비소절구추궁근정봉추간융합기술여전통수술방식치료요추활탈증적림상료효。방법수술치료요추활탈증100례，기중소절구추궁근정봉추간융합기술조50례，전통개방조50례。분별통계량조술중출혈량、수술시간、술후인류량、주원시간，술전술후동통시각VSA평분、Oswestry공능장애지수（ODI），근거Macnab표준평정림상료효，대각영상학수거진행대비분석。결과수방12～24개월，평균18개월，소절구조수술시간、술중출혈량、술후인류량、주원시간、술후수방VAS동통등평분지표균비전통개방수술조구유명현우세（P＜0.01）。소절구조ODI유술전적（84.4±5.3）％감소도술후말차수방적（7.7±1.3）％；전통개방조ODI유술전적（85.9±3.9）％감소도술후말차수방적（19.2±4.9）％，량조차이유통계학의의（ P＜0.01）。결론여전통개방수술상비，소절구추궁근정봉추간융합기술치료요추활탈증부합미창수술적이념，감소료추방조직적엄범박리，구유절구소、주원시간단、회복쾌、술후요통소등우점，료효학절，조작간단，괄합기층의원추엄。
Objective To compare the clinical results between the mini-incision transforaminal lumbar inter-body fusion(mini-incision TLIF) and conventional open approach in treatment of lumbar spondylolisthesis .Methods A total of 100 patients with lumbar spondylolisthesis underwent surgical intervention were retrospectively analyzed ,in-cluding 50 patients with mini-incision TLIF and 50 patients with conventional open opproach .Operation time, intra-operative bleeding , postoperative drainage volume , and hospitalization time were recorded .Pre-and postoperative back pain was assessed by visual analogue scale ( VAS) ,and lumbar function was evaluated by Oswestry disability in-dex(ODI),the clinical results were assessed by Macnab criterion ,and radiologic parameters were compaerd .Results The mean follow-up time was 18 months (ranged,12~24).The group of mini-incision TLIF was superior to the group of conventional open in intra-operative bleeding , operation time , postoperative drainage volume and hospital stay , postoperative VAS ( P<0.01 ) , the ODI in the patients with conventional open approach decreased from ( 85.9 ± 3.9)%before operation to (19.2 ±4.9)%at the final postoperative follow-up.The ODI in the patients with mini-in-cision TLIF decreased from (84.4 ±5.3)%before operation to (7.7 ±1.3)% at the final postoperative follow-up. There was significant difference of the change in ODI between two groups ( P<0.01 ) .Conclusion Compared with conventional approach , mini-incision TLIF meets the concept of minimally invasive surgery in treatment of lumbar spondylolisthesis , avoids wide stripping of the vertebral adjacent tissues ,and has advantages of smaller incision ,shor-ter hospitalization time ,faster posteroperative recovery ,and lower back pain and so no .It has defined clinical efficacy and simple operation ,and is worth popularizing at the basic-level hospitals .