CAJ | 학술논문

目的：比较传统开放性后路腰椎椎间融合术(PLIF)与微创通道(LUXOR)辅助经椎间孔入路腰椎椎间融合术(MIS-TLIF)治疗单节段退行性腰椎疾病的疗效。方法选择采用 LUXOR 通道辅助 MIS-TLIF 手术治疗的单节段退行性腰椎病变患者34例,回顾性分析手术时间、术中出血量、术后引流量、术后卧床时间和术前及随访时的腰背疼痛视觉模拟评分(VAS)、Oswestry 功能障碍评分(ODI)和影像学检查资料,并与同期行传统开放PLIF 手术的30例患者进行比较。结果2组患者性别、年龄、临床诊断、病变节段、术前腰背痛 VAS 评分和ODI 评分差别均无统计学意义(P >0.05)。MIS-TLIF 组手术时间长于 PLIF 组(P <0.05),术中出血量、术后引流量、术后卧床时间及术后3,6月时的 VAS 评分及 ODI 评分均明显低于 PLIF 组(P <0.01)。术后随访影像学显示,所有患者手术节段均在术后半年内获得良好的节段融合。结论与传统 PLIF 手术比较,MIS-TLIF 治疗单节段腰椎退行性疾病具有出血少、术后恢复快、腰背疼痛轻等优点。
목적：비교전통개방성후로요추추간융합술(PLIF)여미창통도(LUXOR)보조경추간공입로요추추간융합술(MIS-TLIF)치료단절단퇴행성요추질병적료효。방법선택채용 LUXOR 통도보조 MIS-TLIF 수술치료적단절단퇴행성요추병변환자34례,회고성분석수술시간、술중출혈량、술후인류량、술후와상시간화술전급수방시적요배동통시각모의평분(VAS)、Oswestry 공능장애평분(ODI)화영상학검사자료,병여동기행전통개방PLIF 수술적30례환자진행비교。결과2조환자성별、년령、림상진단、병변절단、술전요배통 VAS 평분화ODI 평분차별균무통계학의의(P >0.05)。MIS-TLIF 조수술시간장우 PLIF 조(P <0.05),술중출혈량、술후인류량、술후와상시간급술후3,6월시적 VAS 평분급 ODI 평분균명현저우 PLIF 조(P <0.01)。술후수방영상학현시,소유환자수술절단균재술후반년내획득량호적절단융합。결론여전통 PLIF 수술비교,MIS-TLIF 치료단절단요추퇴행성질병구유출혈소、술후회복쾌、요배동통경등우점。
Objective To compare the effect of LUXOR system-assisted minimally invasive sur-gery transforaminal lumbar interbody fusion (MIS-TLIF)with posterior lumbar interbody fusion (PLIF) in treatment for degenerative lumbar diseases. Methods Clinical data of 34 patients with single segment degenerative lumbar disease who underwent MIS-TLIF in our hospital were retrospectively analyzed. The operation time,intraoperative blood loss,postoperative drainage volume,and postoperative bedtime were recorded and compared with those of 30 patients with the same disease who underwent conventional open PLIF during the same period. The back pain visual analogue score (VAS),Oswestry disability in-dex (ODI)score and imaging examination were performed before operation and during follow-up duration for each patient. Results There was no significant difference in the gender,age,clinical diagnosis,le-sion location,VAS and ODI scores before operation between the two groups (P >0.05). The operation time was longer in MIS-TLIF group than in PLIF group (P <0.05);the intraoperative blood loss,postop-erative drainage volume,and postoperative bedtime were lower in MIS-TLIF group than in PLIF group (P <0.01). The back pain VAS scores and ODI scores in the 3rd and 6th month post-operative in MIS-TLIF group were lower than in PLIF group (P < 0.01 ). Radiological follow-up observation revealed good fusion 6 months post-operative in all the patients. Conclusion MIS-TLIF has several advantages o-ver conventional open PLIF,such as less intraoperative blood loss,milder muscle damage,and lighter back pain.