CAJ | 학술논문

目的比较研究导航微创经椎间孔入路椎间植骨融合术(TLIF)与传统切开TLIF治疗腰椎滑脱症的临床疗效. 方法前瞻性地将201 1年5月至2013年3月收治的符合纳入和排除标准的成人腰椎滑脱症患者分为2组,分别接受导航微创TLIF(导航微创组,13例)与传统切开TLIF(传统切开组,14例)治疗,两组患者术前一般资料比较差异均无统计学意义(P＞0.05),具有可比性.比较两组患者的手术时间、出血量、住院时间及术后日本骨科协会(JOA)改善率、Oswestry功能障碍指数(ODI)、视觉模拟评分(VAS)、Odom标准优良率、置钉优良率、滑脱率、复位率及融合率. 结果所有患者均获随访,导航微创组和传统切开组平均随访时间分别为12.4个月和11.5个月.与传统切开组比较,导航微创组的出血量少、JOA改善率和ODI评分低,差异均有统计学意义(P＜0.05).手术时间、住院时间、VAS评分、Odom标准优良率、置钉优良率、滑脱率、复位率及融合率两组间比较差异均无统计学意义(P＞0.05). 结论与传统切开TLIF相比,导航微创TLIF具有手术出血少、肌肉剥离少、手术创伤小、置入螺钉位置精确等优点,具有良好的临床应用前景.
목적 비교연구도항미창경추간공입로추간식골융합술(TLIF)여전통절개TLIF치료요추활탈증적림상료효. 방법 전첨성지장201 1년5월지2013년3월수치적부합납입화배제표준적성인요추활탈증환자분위2조,분별접수도항미창TLIF(도항미창조,13례)여전통절개TLIF(전통절개조,14례)치료,량조환자술전일반자료비교차이균무통계학의의(P＞0.05),구유가비성.비교량조환자적수술시간、출혈량、주원시간급술후일본골과협회(JOA)개선솔、Oswestry공능장애지수(ODI)、시각모의평분(VAS)、Odom표준우량솔、치정우량솔、활탈솔、복위솔급융합솔. 결과 소유환자균획수방,도항미창조화전통절개조평균수방시간분별위12.4개월화11.5개월.여전통절개조비교,도항미창조적출혈량소、JOA개선솔화ODI평분저,차이균유통계학의의(P＜0.05).수술시간、주원시간、VAS평분、Odom표준우량솔、치정우량솔、활탈솔、복위솔급융합솔량조간비교차이균무통계학의의(P＞0.05). 결론 여전통절개TLIF상비,도항미창TLIF구유수술출혈소、기육박리소、수술창상소、치입라정위치정학등우점,구유량호적림상응용전경.
Objective To compare the clinical outcomes of navigation-assisted minimally invasive transforaminal lumbar interbody fusion (TLIF) with traditional fluoroscopy-assisted open TLIF.Methods Between May 2011 and March 2013,27 eligible adult patients with lumbar spondylolisthesis were randomly assigned to receive navigation-assisted minimally invasive TLIF (13 cases) or traditional fluoroscopy-assisted open TLIF (14 cases).The 2 groups were compatible with no significant differences in preoperative general data (P ＞ 0.05).The 2 groups were compared in terms of operation time,intraoperative blood loss,hospital stay,post-operative Japanese Orthopaedic Association (JOA)score,Oswestry disability Index (ODI)score,visual analogue scale (VAS) score,Odom' s evaluation,and rates of good to excellent pedicle insertion,olisthe,reduction and fusion.Results The navigation-assisted TLIF and traditional TLIF groups were followed up respectively for 12.4 and 11.5 months on average.The navigation-assisted minimally invasive TLIF group had significantly less blood loss,greater JOA improvement and lower ODI scores than the traditional open TLIF group (P ＜ 0.05).There were no significant differences between the 2 groups regarding operation time,hospital stay,VAS score,Odom's evaluation,or rates of good to excellent pedicle insertion,olisthe,reduction and fusion (P ＞ 0.05).Conclusion Since navigation-assisted minimally invasive TLIF has advantages of decreased intraoperative blood loss,minimal invasion and accurate pedicle insertion compared with traditional open TLIF,it has a promising prospect of clinical application.