摘要
目的探讨Quadrant微创通道椎间融合内固定术治疗伴腰椎不稳椎间盘突出症的临床疗效。方法 2009年1月至2012年4月,我科治疗腰椎间盘突出症并且获随访57例患者,其中Quadrant微创通道椎间融合内固定治疗23例,开放椎间融合内固定术治疗34例,比较两组术中出血量、术后引流量、手术时间,椎间隙高度,VAS评分和ODI评分。结果所有患者均无定位错误、神经损伤、脑脊液漏、椎间隙感染等严重并发症,与开放手术组相比,Quadrant手术组术中出血量及术后引流量均明显减少(P<0.05),手术时间差异无统计学意义(P>0.05)。Quadrant微创通道手术组与开放手术组在术前、术后1个月及末次随访在椎间隙高度差异均无统计学意义。在VAS评分和ODI评分方面,Quadrant微创通道手术组与开放手术组在术前及随访差异无统计学意义,Quadrant微创通道手术组与开放手术组术后1个月差异有统计学意义。结论Quadrant微创通道椎间融合内固定术组与开放椎间融合内固定术组具有相同临床疗效,Quadrant微创通道椎间融合内固定术在手术创伤方面具有优势,近期疗效好,值得推广。
Objective To investigate the clinical outcomes of minimally invasive fixation and interbody fusion through Quadrant channel in the treatment of lumbar disc herniation accompanied by lumbar instability. Methods From January 2009 to April 2012, 57 patients with lumbar disc herniation were treated and followed up, including 23 patients treated by minimally invasive ifxation and interbody fusion through Quadrant channel and 34 patients treated by open interbody fusion and internal ifxation. The intraoperative blood loss, postoperative drainage, operation time, disc space height, Visual Analogue Scale （ VAS ） score and Oswestry Disability Index （ ODI ） score were compared between the 2 groups. Results No positioning errors, nerve injuries, cerebrospinal lfuid leakage, disc space infection or other serious complications were found in the patients. The intraoperative blood loss and postoperative drainage were obviously decreased in the Quadrant operation group, when compared with that in the open operation group （ P＆lt;0.05 ）. The differences in the operation time were not statistically significant between them （ P＆gt;0.05 ）. There were no statistically signiifcant differences in the disc space height between the 2 groups preoperatively, at 1 month after the operation and in the latest follow-up. As to the VAS and ODI scores, no statistically signiifcant differences existed between the 2 groups preoperatively and in the latest follow-up, and while the differences were statistically significant at 1 month after the operation. Conclusions The same clinical outcomes can be achieved in the group treated by minimally invasive fixation and interbody fusion through Quadrant channel as in the group treated by open interbody fusion and internal fixation. The minimally invasive fixation and interbody fusion through Quadrant channel is worth popularizing, with the advantages of less surgery trauma and better short-term curative effects.
出处
《中国骨与关节杂志》
CAS
2014年第4期257-260,共4页
Chinese Journal of Bone and Joint
关键词
外科手术
微创性
内固定器
椎间盘移位
腰椎
疗效比较研究
Surgical procedures, minimally invasive
Intemal fixators
Intervertebral disc displacement
Lumbar vertebrae
Comparative effectiveness research
