中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2013年
4期
211-214
,共4页
袁振超%陈远明%周先明%黄民锋%黄保华
袁振超%陳遠明%週先明%黃民鋒%黃保華
원진초%진원명%주선명%황민봉%황보화
椎间盘移位%腰椎%外科手术,微创性%椎间盘退行性变%椎间盘切除术,经皮%内窥镜
椎間盤移位%腰椎%外科手術,微創性%椎間盤退行性變%椎間盤切除術,經皮%內窺鏡
추간반이위%요추%외과수술,미창성%추간반퇴행성변%추간반절제술,경피%내규경
Intervertebral disk displacement%Lumbar vertebrae%Surgical procedure, minimally invasive%Intervetebral disc degeneration%Diskectomy, percutaneous%Endoscopes
目的比较通道下经椎间孔腰椎融合内固定术与开放性腰椎融合内固定术治疗复发性腰椎间盘突出症的临床疗效.方法对2008年1月至2011年3月,我院我科的收治复发性腰椎间盘突出症共67例进行回顾性分析,根据手术方式分为开放组( OTLIF )36例和微创组( MITLIF )31例,2组患者术前年龄、性别、术前 JOA 评分差异无统计学意义( P>0.05),具有可比性.OTLIF 组采用了传统的开放性腰椎融合内固定术治疗,MITLIF 组采用通道下经椎间孔腰椎融合内固定术.比较2组患者的手术时间、术中术后出血量、住院时间、术中术后并发症、术后1、3个月和1年 JOA 评分( Japanese Orthopaedic Association Scores )及1年以后椎间融合率.结果所有患者均获得随访,随访时间为14~46个月,平均27.3个月,MITLIF 组的术中术后出血量(193.4±43.5) ml、术后住院时间(13.5±1.8)天、术后2周 JOA 评分(15.3±1.6),OTLIF 组出血量(454.1±79.4) ml、术后住院时间(6.8±2.1)天、术后2周 JOA 评分(19.5±1.9),两组差异具有统计学意义( P<0.05).2组手术时间,术中术后并发症发生率,术后1、3个月和1年 JOA 评分及腰椎融合率的差异无统计学意义( P>0.05).结论通道下经椎间孔微创腰椎融合内固定术治疗复发型腰椎间盘突出症较传统开放式经椎间孔腰椎融合术具有出血少、住院时间短、术后恢复快等优点,能取得较好的早期临床疗效,但两组的中期疗效相当.
目的比較通道下經椎間孔腰椎融閤內固定術與開放性腰椎融閤內固定術治療複髮性腰椎間盤突齣癥的臨床療效.方法對2008年1月至2011年3月,我院我科的收治複髮性腰椎間盤突齣癥共67例進行迴顧性分析,根據手術方式分為開放組( OTLIF )36例和微創組( MITLIF )31例,2組患者術前年齡、性彆、術前 JOA 評分差異無統計學意義( P>0.05),具有可比性.OTLIF 組採用瞭傳統的開放性腰椎融閤內固定術治療,MITLIF 組採用通道下經椎間孔腰椎融閤內固定術.比較2組患者的手術時間、術中術後齣血量、住院時間、術中術後併髮癥、術後1、3箇月和1年 JOA 評分( Japanese Orthopaedic Association Scores )及1年以後椎間融閤率.結果所有患者均穫得隨訪,隨訪時間為14~46箇月,平均27.3箇月,MITLIF 組的術中術後齣血量(193.4±43.5) ml、術後住院時間(13.5±1.8)天、術後2週 JOA 評分(15.3±1.6),OTLIF 組齣血量(454.1±79.4) ml、術後住院時間(6.8±2.1)天、術後2週 JOA 評分(19.5±1.9),兩組差異具有統計學意義( P<0.05).2組手術時間,術中術後併髮癥髮生率,術後1、3箇月和1年 JOA 評分及腰椎融閤率的差異無統計學意義( P>0.05).結論通道下經椎間孔微創腰椎融閤內固定術治療複髮型腰椎間盤突齣癥較傳統開放式經椎間孔腰椎融閤術具有齣血少、住院時間短、術後恢複快等優點,能取得較好的早期臨床療效,但兩組的中期療效相噹.
목적비교통도하경추간공요추융합내고정술여개방성요추융합내고정술치료복발성요추간반돌출증적림상료효.방법대2008년1월지2011년3월,아원아과적수치복발성요추간반돌출증공67례진행회고성분석,근거수술방식분위개방조( OTLIF )36례화미창조( MITLIF )31례,2조환자술전년령、성별、술전 JOA 평분차이무통계학의의( P>0.05),구유가비성.OTLIF 조채용료전통적개방성요추융합내고정술치료,MITLIF 조채용통도하경추간공요추융합내고정술.비교2조환자적수술시간、술중술후출혈량、주원시간、술중술후병발증、술후1、3개월화1년 JOA 평분( Japanese Orthopaedic Association Scores )급1년이후추간융합솔.결과소유환자균획득수방,수방시간위14~46개월,평균27.3개월,MITLIF 조적술중술후출혈량(193.4±43.5) ml、술후주원시간(13.5±1.8)천、술후2주 JOA 평분(15.3±1.6),OTLIF 조출혈량(454.1±79.4) ml、술후주원시간(6.8±2.1)천、술후2주 JOA 평분(19.5±1.9),량조차이구유통계학의의( P<0.05).2조수술시간,술중술후병발증발생솔,술후1、3개월화1년 JOA 평분급요추융합솔적차이무통계학의의( P>0.05).결론통도하경추간공미창요추융합내고정술치료복발형요추간반돌출증교전통개방식경추간공요추융합술구유출혈소、주원시간단、술후회복쾌등우점,능취득교호적조기림상료효,단량조적중기료효상당.
Objective To compare the clinical outcomes of through-channel transforaminal and open lumbar interbody fusion and internal fixation in the treatment of recurrent lumbar disc herniation. Methods The data of 67 patients with recurrent lumbar disc herniation who were adopted from January 2008 to March 2011 were retrospectively analyzed. All patients were divided into 2 groups according to the surgical methods, including 36 patients undergoing open transforaminal lumbar interbody fusion ( OTLIF ) and 31 patients undergoing minimally invasive transforaminal lumbar interbody fusion ( MITLIF ). The differences in age, gender, Japanese Orthopedic Association ( JOA ) scores preoperatively between the 2 groups were not statistically significant ( P>0.05 ), indicating that they are comparative. The patients in the OTLIF group were treated with traditional open lumbar fusion and internal fixation, and the patients in the MITLIF group were treated with through-channel transforaminal lumbar fusion and internal fixation. The operation time, intraoperative and postoperative blood loss, length of hospital stay, intraoperative and postoperative complications, JOA scores 1, 3 and 12 months after the operation and intervertebral fusion rates 1 year after the operation were compared between the 2 groups. Results All patients were followed up for a mean period of 27.3 months ( range; 14-46 months ). In the MITLIF group, the intraoperative and postoperative blood loss was ( 193.4±43.5 ) ml. The duration of postoperative hospital stay was ( 13.5±1.8 ) days. 2 weeks after the operation, the JOA score was ( 15.3±1.6 ). In the OTLIF group, the blood loss was ( 454.1±79.4 ) ml. The postoperative duration of hospital stay was ( 6.8±2.1 ) days. 2 weeks after the operation, the JOA score was ( 19.5±1.9 ). The differences between the 2 groups were statistically significant ( P<0.05 ). The differences in operation time, intraoperative and postoperative incidences of complications, JOA scores 1, 3 and 12 months after the operation and lumbar fusion rates between the 2 groups were not statistically significant ( P>0.05 ). Conclusions The through-channel MITLIF and internal fixation has the advantages of less blood loss, shorter hospitalization time and rapid postoperative recovery in the treatment of recurrent lumbar disc herniation, with better early-term clinical outcomes when compared with the traditional open TLIF. However, the medium-term results are similar between the 2 groups.
