CAJ | 학술논문

目的：观察健侧Wiltse入路结合患侧常规后方显露改良TLIF手术治疗极外侧型腰椎间盘突出症的临床疗效。方法回顾分析2010年1月-2013年1月行健侧Wiltse入路结合患侧常规后方显露改良TLIF手术治疗的单节段极外侧腰椎间盘突出症24例的临床资料,记录手术时间、术中出血量、术后引流量、并发症。分析比较术前及术后腰痛及下肢放射痛的视觉模拟(VAS)评分、Oswestry功能障碍指数(ODI),以及术前及术后1年多裂肌残存率。结果手术时间(129±17) min,术中出血量(173±42)ml,术后引流量(101±16)ml。术后14 d及术后1年腰、腿疼痛VAS评分与术前比较差异有统计学意义(P<0．05),术后1年ODI与术前ODI值差异具有统计学意义(P<0．05)。健侧与患侧术后1年多裂肌残存率的差异存在统计学意义(P<0．05)。结论 Wiltse入路能够减少多裂肌损伤,可用于仅行单侧减压的腰椎间盘突出症患者。
목적：관찰건측Wiltse입로결합환측상규후방현로개량TLIF수술치료겁외측형요추간반돌출증적림상료효。방법회고분석2010년1월-2013년1월행건측Wiltse입로결합환측상규후방현로개량TLIF수술치료적단절단겁외측요추간반돌출증24례적림상자료,기록수술시간、술중출혈량、술후인류량、병발증。분석비교술전급술후요통급하지방사통적시각모의(VAS)평분、Oswestry공능장애지수(ODI),이급술전급술후1년다렬기잔존솔。결과수술시간(129±17) min,술중출혈량(173±42)ml,술후인류량(101±16)ml。술후14 d급술후1년요、퇴동통VAS평분여술전비교차이유통계학의의(P<0．05),술후1년ODI여술전ODI치차이구유통계학의의(P<0．05)。건측여환측술후1년다렬기잔존솔적차이존재통계학의의(P<0．05)。결론 Wiltse입로능구감소다렬기손상,가용우부행단측감압적요추간반돌출증환자。
Objective To observe the clinical effects of unaffected side of Wiltse approach combined with traditional mod-ified transforaminal lumbar interbody fusion (TLIF) in treatment of far lateral lumbar intervertebral disc protrusion. Methods Clinical data of 24 patients with single segment of far lateral lumbar intervertebral disc protrusion recorded during January 2010 and January 2013, who were treated with unaffected side of Wiltse approach combined with traditional modified TLIF, was retrospec-tively analyzed. The operation time, intraoperative blood loss, postoperative drainage volume and complications were also recor-ded. Values of visual analogue scale (VAS) in low back pain and leg pain, and Oswestry disability index (ODI) before and after the operation were analyzed and compared, and the residual rate of multifidus muscles before and one year after the operation were also recorded and compared. Results The operation time was (129 ± 17)min, the intraoperative blood loss was (173 ± 42)ml, and postoperative drainage volume was (101 ± 16)ml. The differences of VAS scores in low back and leg pain before and 14 d or one year after the operation were statistically significant (P<0. 05). The difference of ODI value before and one year after the opera-tion was statistically significant (P<0. 05). The difference in residual rate of multifidus muscle between unaffected side and affect-ed side one year after surgery was statistically significant (P<0. 05). Conclusion Wiltse approach may minimize the injury of multifidus muscle, and can be used in lumbar intervertebral disc protrusion patients with unilateral decompression.