摘要
目的：探讨应用经椎间孔椎体间融合（ TLIF）技术治疗胸腰段间盘突出症的可行性。方法回顾2009年12月至2013年5月天津医院脊柱外科15例采用后路椎板切除减压＋TLIF技术治疗的单节段胸腰段间盘突出症患者资料。男9例，女6例；年龄平均41．2（25～72）岁。所有患者按照日本骨科协会（ JOA）29分法以及Frankel神经功能分级标准进行临床疗效评估。结果手术时间平均140（115～180）min；术中出血量平均320（100～500） ml。所有患者全程随访，随访时间平均19（3～44）个月。随访期内全部患者的症状均有不同程度的恢复和改善，无复发病例。末次随访按照JOA评分标准，改善率优9例，良4例，可2例；优良13例，有效15例。按照Frankel神经功能分级标准，术前：A级2例，B级2例，C级4例，D级7例；术后：B级1例，C级1例，D级4例，E级9例。结论应用TLIF技术联合后路椎板切除减压治疗胸腰段间盘突出症具有解剖简单，术野清晰，操作简便、安全，减压彻底、有效，固定融合可靠等优点。
Objective To explore the feasibility , safety and efficacy of treating thoracolumbar disc herniation with transforaminal lumbar intervertebral fusion （ TLIF） .Methods From December 2009 to May 2013, 15 consecutive patients with one-level thoracolumbar disc herniation underwent TLIF .There were 9 males and 6 females with an average age of 41.2 （25-72） years.According to the Japanese Orthopedic Association （ JOA ） criteria and Frankel grading system , it was evaluated for the clinical effects of all patients.Results The average operative duration was 140 （115-180） min and mean blood loss volume 329 （100-500） ml.The symptoms improved all greatly over an average follow-up period of 19 （3-44） months.According to the JOA criteria system, the outcomes were excellent （n=9, 60%）, good （n=4, 26.6%） and fair （n=2, 13.4%）.Based on the Frankel grading system , 2 cases were classified as A （n=2）, 2 as B （n=2）, 4 as C （n=4） and 7 as D （n=7） preoperatively versus B （n=1）, C （n=1）, D （ n=4 ） and E （ n =9 ） postoperatively .Conclusion The combined approach of TLIF plus posterior laminectomy is anatomically simple, visually distinct, relatively safe, reliable and efficacious in treatment of thoracolumbar disc herniation .
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第25期1947-1951,共5页
National Medical Journal of China
关键词
椎间盘
脊柱融合
胸椎
腰椎
Intervertebral disk
Spinal fusion
Thoracic vertebrea
Lumbar vertebrea
