CAJ | 학술논문

目的：探讨后路减压经椎间孔椎间融合术( transforminal lumbar interbody fusion,TLIP)治疗钙化型高位腰椎间盘突出症的临床疗效。方法2008年1月至2011年12月采用全椎板切除TLIP技术治疗的钙化型高位腰椎间盘突出症患者19例。男10例,女9例；年龄23~58岁,平均41．2岁。其中L1/24例,L2/38例,L3/47例。合并T12/L1突出1例,其余均为单间隙椎间盘突出。术前、末次随访时进行疼痛视觉模拟评分( VAS)、Oswestry功能障碍指数( ODI)评分,根据Otani方法评定疗效。结果所有病例获得随访,随访时间3~24个月,平均12个月。术中3例硬脊膜损伤,术后脑脊液漏,经加压包扎处理后痊愈,1例出现对侧神经牵拉症状,经对症处理后缓解。1例术后症状无恢复。术前VAS评分与ODI评分分别为(8．1±1．4)分、(57．79±1．90)%,末次随访 VAS 评分与 ODI 评分分别为(2．2±1．0)分、(20．53±0．3)%。均较术前有统计学差异(P<0．05)。根据Otani分级方法评定疗效：优9例,良6例,进步3例,差1例。优良率78．9%。结论采用后路减压经椎间孔椎间融合术治疗钙化型高位腰椎间盘突出症可获得较满意疗效。
목적：탐토후로감압경추간공추간융합술( transforminal lumbar interbody fusion,TLIP)치료개화형고위요추간반돌출증적림상료효。방법2008년1월지2011년12월채용전추판절제TLIP기술치료적개화형고위요추간반돌출증환자19례。남10례,녀9례；년령23~58세,평균41．2세。기중L1/24례,L2/38례,L3/47례。합병T12/L1돌출1례,기여균위단간극추간반돌출。술전、말차수방시진행동통시각모의평분( VAS)、Oswestry공능장애지수( ODI)평분,근거Otani방법평정료효。결과소유병례획득수방,수방시간3~24개월,평균12개월。술중3례경척막손상,술후뇌척액루,경가압포찰처리후전유,1례출현대측신경견랍증상,경대증처리후완해。1례술후증상무회복。술전VAS평분여ODI평분분별위(8．1±1．4)분、(57．79±1．90)%,말차수방 VAS 평분여 ODI 평분분별위(2．2±1．0)분、(20．53±0．3)%。균교술전유통계학차이(P<0．05)。근거Otani분급방법평정료효：우9례,량6례,진보3례,차1례。우량솔78．9%。결론채용후로감압경추간공추간융합술치료개화형고위요추간반돌출증가획득교만의료효。
Objective To study the clinical efficacy of posterior decompression transforaminal lumbar interbody fusion ( TLIP) in treatment of calcified upper lumbar intervertebral disc herniation. Methods A total of 10 male patients and 9 female patients with calcified upper lumbar intervertebral disc herniation received TLIP between January 2008 and December 2011 were included in this analysis. The mean age of the patients was 41. 2 years (range,23 to 58). Single segment disc herniation was 18 ca-ses:L1/L2 4 cases,L2/L3 8 cases and L3/L4 7 cases. Multi-segment disc herniation was 1 case:L1/L2+T12/L1. Oswestry dis-ability index ( ODI) and visual analog pain scores ( VAS) were evaluated before surgery and at the final follow-up. Clinical efficacy was assessed by Otani’s criterion. Results All cases were followed up at a median follow-up of 12 months (range,3 to 24). A total of 3 cases of intraoperative dural injuries were recorded,one case with cerebrospinal leak was cure by compression dressing,one case with the contralateral nerve symptoms was relieved by symptomatic treatment and another case was not recovery. The ODI and VAS scores were significantly decreased from(8.1 ±1.4)to(2.2 ±1.0)and from(57.79 ±1.90)% to(20.53 ±0.3)% respec-tively between the preoperative and the final follow-up (P>0. 05). According to Otani’s criteria,the results were excellent in 9 ca-ses,good in 6 cases,improved in 3 cases,fair in 1 case,and poor in 1 case with an excellent and good rate of 78. 9%. Conclusion Posterior decompression TLIP is effective in the treatment of patients with calcified upper lumbar intervertebral disc herniation.