中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
27期
3252-3255
,共4页
尚晖%岑毕文%王达义%常巍%郭振鹏%杨棋
尚暉%岑畢文%王達義%常巍%郭振鵬%楊棋
상휘%잠필문%왕체의%상외%곽진붕%양기
椎间盘移位%MASTTM QUADRANTTM微创可扩张通道%椎间盘切除术%脊柱椎融合术
椎間盤移位%MASTTM QUADRANTTM微創可擴張通道%椎間盤切除術%脊柱椎融閤術
추간반이위%MASTTM QUADRANTTM미창가확장통도%추간반절제술%척주추융합술
Intervertebral disk displacement%MASTTM QUADRANTTM minimally invasive channel%Diskectomy%Spinal fusion
目的:在MASTTM QUADRANTTM微创可扩张通道下对极外侧型腰椎间盘突出症( FLLDH)行突出椎间盘切除、椎间孔腰椎融合术( TLIF)治疗,观察其疗效。方法选取2011年3月-2013年1月湖北省十堰市太和医院脊柱外科收治并确诊的24例FLLDH患者行突出椎间盘切除结合TLIF,对患者术前、术后的腰椎日本骨科协会( JOA)评分和MacNad疗效评定标准进行分析,评价疗效。结果本组24例患者均获得随访,随访时间为6个月~2年,平均14个月,椎间孔型17例,术前JOA评分平均(8.24±3.15)分,术后平均(24.23±2.15)分,术前术后JOA评分比较有差异(t越17.287,P越0.000);椎间孔外型7例,术前JOA评分平均(9.35±3.23)分,术后平均(23.89±2.55)分,术前术后JOA评分比较有差异(t越9.378,P越0.000);MacNad评定结果:优12例、良9例、可3例;优良率为87.5%(21/24)。复查腰椎正侧位片、腰椎CT显示植骨愈合良好、椎间隙无明显塌陷、内固定物无松动。所有患者术后伤口一期愈合,未出现神经损伤并发症。结论微创可扩张通道下对 FLLDH的突出椎间盘切除并行TLIF,手术操作方便,疗效可靠,是一种较好的手术方法。
目的:在MASTTM QUADRANTTM微創可擴張通道下對極外側型腰椎間盤突齣癥( FLLDH)行突齣椎間盤切除、椎間孔腰椎融閤術( TLIF)治療,觀察其療效。方法選取2011年3月-2013年1月湖北省十堰市太和醫院脊柱外科收治併確診的24例FLLDH患者行突齣椎間盤切除結閤TLIF,對患者術前、術後的腰椎日本骨科協會( JOA)評分和MacNad療效評定標準進行分析,評價療效。結果本組24例患者均穫得隨訪,隨訪時間為6箇月~2年,平均14箇月,椎間孔型17例,術前JOA評分平均(8.24±3.15)分,術後平均(24.23±2.15)分,術前術後JOA評分比較有差異(t越17.287,P越0.000);椎間孔外型7例,術前JOA評分平均(9.35±3.23)分,術後平均(23.89±2.55)分,術前術後JOA評分比較有差異(t越9.378,P越0.000);MacNad評定結果:優12例、良9例、可3例;優良率為87.5%(21/24)。複查腰椎正側位片、腰椎CT顯示植骨愈閤良好、椎間隙無明顯塌陷、內固定物無鬆動。所有患者術後傷口一期愈閤,未齣現神經損傷併髮癥。結論微創可擴張通道下對 FLLDH的突齣椎間盤切除併行TLIF,手術操作方便,療效可靠,是一種較好的手術方法。
목적:재MASTTM QUADRANTTM미창가확장통도하대겁외측형요추간반돌출증( FLLDH)행돌출추간반절제、추간공요추융합술( TLIF)치료,관찰기료효。방법선취2011년3월-2013년1월호북성십언시태화의원척주외과수치병학진적24례FLLDH환자행돌출추간반절제결합TLIF,대환자술전、술후적요추일본골과협회( JOA)평분화MacNad료효평정표준진행분석,평개료효。결과본조24례환자균획득수방,수방시간위6개월~2년,평균14개월,추간공형17례,술전JOA평분평균(8.24±3.15)분,술후평균(24.23±2.15)분,술전술후JOA평분비교유차이(t월17.287,P월0.000);추간공외형7례,술전JOA평분평균(9.35±3.23)분,술후평균(23.89±2.55)분,술전술후JOA평분비교유차이(t월9.378,P월0.000);MacNad평정결과:우12례、량9례、가3례;우량솔위87.5%(21/24)。복사요추정측위편、요추CT현시식골유합량호、추간극무명현탑함、내고정물무송동。소유환자술후상구일기유합,미출현신경손상병발증。결론미창가확장통도하대 FLLDH적돌출추간반절제병행TLIF,수술조작방편,료효가고,시일충교호적수술방법。
Objective Toevaluatetheclinicaleffectofdiscectomy and TLIFinthe treatment of farlaterallumbardisc herniation(FLLDH) with MASTTMQUADRANTT Mminimally invasive channel.Methods 24casesofFLLDHadmittedtothede-partment of spinal surgery of Taihe Hospital in Shiyan,Hubei Province from March 2011 to January 2013 were given discectomy and TLIF. The scores of lumbar JOA before and after operation were analyzed,and the TLIF effect was evaluated by using modi-fiedMacNadcriterion.Results Allthe24patientswerefollowedupforsixmonthstotwoyears,withanaverageof14 months. The average JOA score of the 17 cases of foraminal disc herniation was(8. 24 ±3. 15)before operation,and was (24. 23±2. 15)during the follow up,showing statistically significant difference(t=17. 287,P=0. 000). The average JOA score of the 7 cases of extraforaminal disc herniation was(9. 35 ±3. 23),and was(23. 89 ±2. 55)after operation,showing statistically significant difference(t=9. 378,P=0. 000). The evaluation results of MacNad showed that 12 cases were excel-lent,9 cases were good and 3 cases were fair,with an overall excellent and good results rate of 87. 5%. Anteroposterior imagings and CT of lumbar showed that interbody fusion was good and there were no instances of postoperative wound infection or nerve in-juryinanygroup.℅onclusion TheoperationofdiscectomyandTLIFinthetreatmentofFLLDHwithminimallyinvasivechannel is an effective method,which has less tissue trauma,less complications and satisfactory clinical results.