摘要
[目的]分析采用Quadrant微创系统经肌间隙入路和经肌肉入路治疗退变性腰椎疾病的临床疗效。[方法]2009年9月～2012年3月,对26例腰椎退变性疾病患者采用Quadrant微创系统进行腰椎减压融合内固定手术。随机选择经肌间隙和经肌肉至目标部位两种入路,比较两组患者的围手术期参数(手术时间、出血量、暴露入路时切除的软组织量、住院时间、并发症发生情况)和临床随访时的疗效(腰腿痛VAS、ODI评分)。[结果]所有患者均顺利完成手术,并完成半年以上的临床随访,无术中及术后并发症发生。在围手术期参数比较中,采用经肌肉入路暴露过程中切除的软组织量少于经肌间隙入路(P<0.05),其他参数比较无显著性差异(P>0.05)。在临床随访中,与术前比较两组均有效缓解临床症状(P<0.05),但在两组之间比较差异性不大(P>0.05),两种入路均能有效进行减压固定操作。[结论]采用Quadrant微创系统不同入路治疗退变性腰椎疾病均能有效减压、重建脊柱稳定性,两种术式在临床疗效上差异性不大,但是经肌肉入路手术治疗暴露后肌肉组织张力明显减小、操作空间较大,更适于复杂操作的完成。
[Objective]To investigate the short-term clinical curative effects of the Mast Quadrant minimally invasive system in the treatment of degenerative lumbar diseases by thoracolumbar vertebra-side muscle clearance approach and by muscle approach.[Methods]Twenty-six patients with degenerative lumbar diseases were divided into thoracolumbar vertebra-side muscle clearance approach group and muscle approach group from September 2009 to March 2012.The perioperative parameters（the operation time,intraoperatve blood soss,the quality of the soft tissue of the resection and hospitalization time） and the follow-up clinical curative effect（lumbocrural pain VAS and ODI） were compared.[Results]All surgery were successfully completed and got more than 6 months follow-up.The quality of the soft tissue of the resection of muscle approach group was better than that of thoracolumbar vertebra-side muscle clearance approach group（P＆lt;0.05）.Other perioperative parameters had no significant differences（P＆gt;0.05）.And two groups obtained approximate clinical curative effect with conventional surgery（P＆gt;0.05）.[Conclusion]The Quadrant minimally invasive system in the treatment of degenerative lumbar diseases by different accesses both can decompress effectively and rebuild spinal stability.And there is no difference in clinical curative effect.But muscle approach group decreased muscle tension obviously and gained greater operating space,which is more suitable for complex surgery.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第17期1720-1724,共5页
Orthopedic Journal of China
关键词
Quadrant微创系统
腰椎退变
微创手术
手术入路
临床疗效
Quadrant minimally invasive system
degenerative lumbar diseases
minimally invasive surgery
surgery approach
clinical curative effect
