摘要
[目的]初步探讨内窥镜下后路腰椎椎体间融合(PLIF)附加单侧椎弓根螺钉固定的临床应用价值。[方法]对2005年7月～2008年9月本科采用内窥镜下PLIF附加单侧椎弓根螺钉固定手术的32例患者、传统开放双侧椎弓根螺钉固定手术的37例患者的临床结果进行评价。随访时间24～37个月,平均32.4个月。对比术中出血量、术后引流量、手术时间及术后住院日;对比术前、术后的腰痛视觉模拟疼痛评分(VAS)和日本矫形外科协会(JOA)下腰痛评分;观察并发症的发生及术后椎间融合情况。[结果]单侧组手术时间、术中出血量、术后引流量、术后住院时间均少于双侧组(P<0.05)。单侧组术后第3 d腰痛VAS评分低于双侧组(P=0.016)。单侧组术后优良率为100%(32例),椎间融合率为93.8%(30例),并发症发生率为9.4%(3例),与双侧组相比差异无统计学意义(P>0.05)。[结论]对于单节段病变且只需要单侧操作即可完成减压和椎间融合、而非手术侧结构完整者而言,内窥镜下PLIF附加单侧椎弓根螺钉固定是一种可供临床选择的微创手术方式。
[Objective] To evaluate the efficacy of posterior lumbar interbody fusion （PLIF） with unilateral pedicle screw fixation on the lumbar stability and the strategies of its reconstruction performed with microendoscopic approach. [ Methods] A consecutive series of 69 patients who underwent one - level PLIF procedure （ 32 cases performed with unilateral pedicle screw fix- ation and 37 cases with traditional open approach） from July 2005 to September 2008 were analyzed retrospectively. The following data were compared between 2 groups with 24 to 37 months follow - up ： estimated blood loss, postoperative drainage, surgical time, length of hospital stay, postoperative back pain by visual analogue scale, complications, and the clinical and radiographic results. [ Results ] The unilateral approach was found to have a significantly less blood loss, less postoperative drainage, shor- ter surgical time, less postoperative back pain, shorter recovery time and shorter length of hospital stay. There was no significant difference between 2 groups in the aspects of the complications and the clinical and radiographic results. [ Conclusion ] There are optional strategies for suitable patients with one - level pathological changes, unilateral discectomy, spinal nerve root decom- pression, lumbar interbody fusion, and integral contralateral construction, by using the one -level PLIF with unilateral fixation performed with microendoscopic approach.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2012年第23期2113-2116,共4页
Orthopedic Journal of China
基金
国家自然科学基金资助项目(编号:31070876
81071493)
关键词
内窥镜脊柱外科
椎体间融合术
腰椎
microendoscopic spine surgery, interbody fusion, lumbar
