中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
37期
2929-2933
,共5页
庄青山%徐兆万%隋国侠%伦登兴%钟军%张扬%季玉栋
莊青山%徐兆萬%隋國俠%倫登興%鐘軍%張颺%季玉棟
장청산%서조만%수국협%륜등흥%종군%장양%계옥동
椎间盘移位%腰椎%脊柱融合术%外科器械
椎間盤移位%腰椎%脊柱融閤術%外科器械
추간반이위%요추%척주융합술%외과기계
Intervertebral disk displacement%Lumbar vertebrae%Spinal fusion%Surgical instruments
目的 探讨Quadrant通道下微创经椎间孔椎间融合术治疗高位腰椎间盘突出症的临床疗效.方法 2008年2月至2011年6月,在Quadrant通道下经椎间孔入路“L”型截骨刀经椎间孔截骨,“齿槽状”绞刀处理椎间盘及终板,椎间植骨融合内固定术治疗高位腰椎间盘突出症患21例,采用视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评估患者术前、术后1周、术后3个月及末次随访时患者疼痛及功能恢复情况,并对椎间植骨融合情况进行随访.结果 21例患者均顺利完成,手术时间2.5～3h,平均2.8h;平均出血量430 (350～ 500) ml,术中无硬膜损伤.术前VAS、ODI分别为(7.3±0.8)、(43.7±12.9)分,术后1周、3个月、末次随访时VAS、ODI分别为(2.1±0.9)、(22.5±10.4)、(1.3±0.6)、(16.2±8.5)、(0.6±0.5)、(11.3±7.2)分,术后1周与术前比较,术后3个月较术后1周,末次随访较术后3个月比较差异均有统计学意义(P＜0.05),植骨融合率为100％.结论 Quadrant通道微创TLIF技术,应用自行设计的“L”型截骨刀及“齿槽状”绞刀治疗高位腰椎间盘突出症取得了满意的临床效果.
目的 探討Quadrant通道下微創經椎間孔椎間融閤術治療高位腰椎間盤突齣癥的臨床療效.方法 2008年2月至2011年6月,在Quadrant通道下經椎間孔入路“L”型截骨刀經椎間孔截骨,“齒槽狀”絞刀處理椎間盤及終闆,椎間植骨融閤內固定術治療高位腰椎間盤突齣癥患21例,採用視覺模擬評分(VAS)、Oswestry功能障礙指數(ODI)評估患者術前、術後1週、術後3箇月及末次隨訪時患者疼痛及功能恢複情況,併對椎間植骨融閤情況進行隨訪.結果 21例患者均順利完成,手術時間2.5～3h,平均2.8h;平均齣血量430 (350～ 500) ml,術中無硬膜損傷.術前VAS、ODI分彆為(7.3±0.8)、(43.7±12.9)分,術後1週、3箇月、末次隨訪時VAS、ODI分彆為(2.1±0.9)、(22.5±10.4)、(1.3±0.6)、(16.2±8.5)、(0.6±0.5)、(11.3±7.2)分,術後1週與術前比較,術後3箇月較術後1週,末次隨訪較術後3箇月比較差異均有統計學意義(P＜0.05),植骨融閤率為100％.結論 Quadrant通道微創TLIF技術,應用自行設計的“L”型截骨刀及“齒槽狀”絞刀治療高位腰椎間盤突齣癥取得瞭滿意的臨床效果.
목적 탐토Quadrant통도하미창경추간공추간융합술치료고위요추간반돌출증적림상료효.방법 2008년2월지2011년6월,재Quadrant통도하경추간공입로“L”형절골도경추간공절골,“치조상”교도처리추간반급종판,추간식골융합내고정술치료고위요추간반돌출증환21례,채용시각모의평분(VAS)、Oswestry공능장애지수(ODI)평고환자술전、술후1주、술후3개월급말차수방시환자동통급공능회복정황,병대추간식골융합정황진행수방.결과 21례환자균순리완성,수술시간2.5～3h,평균2.8h;평균출혈량430 (350～ 500) ml,술중무경막손상.술전VAS、ODI분별위(7.3±0.8)、(43.7±12.9)분,술후1주、3개월、말차수방시VAS、ODI분별위(2.1±0.9)、(22.5±10.4)、(1.3±0.6)、(16.2±8.5)、(0.6±0.5)、(11.3±7.2)분,술후1주여술전비교,술후3개월교술후1주,말차수방교술후3개월비교차이균유통계학의의(P＜0.05),식골융합솔위100％.결론 Quadrant통도미창TLIF기술,응용자행설계적“L”형절골도급“치조상”교도치료고위요추간반돌출증취득료만의적림상효과.
Objective To evaluate the treatment outcomes of mini-invasive transforaminal lumbar interbody fusion by Quadrant system for upper lumbar disc herniation.Methods Between February 2008 and June 2011,21 patients with upper lumbar disc herniation underwent mini-invasive transforaminal lumbar interbody fusion under Quadrant system at our institution.The relevant patient data included visual analogue scale (VAS) and Oswestry disability index (ODI) scores before and after operation 1 week,3 months and last follow-up.And all data were collected retrospectively.Results No operation-related complications occurred.The mean operative duration was 2.8 (2.5-3) hours.The average blood loss volume was 430 (350-500) ml.Preoperative VAS was 7.3 ± 0.8 and 2.1 ± 0.9,1.3 ± 0.6,0.6 ± 0.5 after operation 1 week,3 months and last follow-up respectively.Statistically significant differences were demonstrated between each group.Preoperative ODI was 43.7 ± 12.9 and 22.5 ± 10.4,16.2 ± 8.5,11.3 ± 7.2 after operation 1 week,3 months and last follow up.Significant differences existed in preoperative and postoperative ODI scores respectively.Conclusion Mini-invasive transforaminal lumbar interbody fusion using Quadrant system and special osteotome is safe and efficacious for upper lumbar disc herniation.
