CAJ | 학술논문

目的：探讨通过Quadrant系统改良经椎间孔椎间融合术（改良TLIF）治疗腰椎退变性疾病的临床疗效。方法对收治的87例腰椎退变性疾病患者均采用后路中央两旁多裂肌间隙入路，在Quadrant 可扩张通道微创系统下行改良TLIF。采用视觉模拟法（ VAS）疼痛评分和日本矫形外科协会（ JOA）评分评估临床疗效，并观察术前、术后各项指标及并发症情况。结果87例患者的平均手术时间为189 min，平均手术切口长度为4．1 cm，术中平均出血量为260 ml，术后平均引流量为105 ml。并发硬脊膜破裂2例，经相应处理后治愈。所有患者随访时间平均为13．5个月，术后1周及末次随访时的腰腿痛VAS评分、JOA评分与术前相比明显降低，差异有统计学意义（ P＜0．05）。结论应用Quadrant可扩张通道改良TLIF治疗腰椎退变性疾病，对组织损伤轻、出血量少、术后恢复快、近期疗效肯定，是一种安全有效的微创术式。
목적：탐토통과Quadrant계통개량경추간공추간융합술（개량TLIF）치료요추퇴변성질병적림상료효。방법대수치적87례요추퇴변성질병환자균채용후로중앙량방다렬기간극입로，재Quadrant 가확장통도미창계통하행개량TLIF。채용시각모의법（ VAS）동통평분화일본교형외과협회（ JOA）평분평고림상료효，병관찰술전、술후각항지표급병발증정황。결과87례환자적평균수술시간위189 min，평균수술절구장도위4．1 cm，술중평균출혈량위260 ml，술후평균인류량위105 ml。병발경척막파렬2례，경상응처리후치유。소유환자수방시간평균위13．5개월，술후1주급말차수방시적요퇴통VAS평분、JOA평분여술전상비명현강저，차이유통계학의의（ P＜0．05）。결론응용Quadrant가확장통도개량TLIF치료요추퇴변성질병，대조직손상경、출혈량소、술후회복쾌、근기료효긍정，시일충안전유효적미창술식。
Objective To investigate the clinical outcomes of Quadrant system modified transforaminal lum -bar interbody fusion ( modified TLIF) for treatment of lumbar degenerative disease .Methods Eigty-seven patients with lumbar degenerative disease were treated by modified TLIF assisted by Quadrant expandable tube channel mini -mally invasive system , via posterior multifidus muscle gap approach .Clinical outcomes were assessed by the VAS pain scores and JOA scores .Pre-operative and post-operative conditions and complicaions were monitored .Results In all of 87 patients, the mean operation time was 189 min, the mean incision length was 4.1 cm, the mean operative blood loss was 260 ml and the post-operative drainage was 105 ml.Two patients complicated with dural tears were cured after treatment .All patients were followed-up for 13.5 months, VAS pain scores and JOA scores of one week post-operation and last visit were significantly lower than that of pre-operation ( P<0.05 ) .Conclusion Applying Quadrant expandable tube channel modified TLIF for treatment of lumbar degenerative disease had the advantages of less damage, bleeding and time for recovery , with acknowledged short-term outcomes.It is a safe and effective mini-mally invasive operation method .