摘要
目的通过比较Mast Quadrant通道与开放式经椎间孔腰椎融合术治疗单节段腰椎间盘突出症有效性及安全性,验证Mast Quadrant通道治疗腰椎间盘突出症的长期有效性。方法 2009年1月至2010年12月就诊于我院的单节段腰椎间盘突出症患者随机分为两组,分别进行Mast Quadrant通道(微创组)与开放式(常规组)经椎间孔腰椎融合术。术后对受试者随访4年以上,并对术中相关指标及术后观察结果进行随访比较。通过统计学软件对两组的观察指标进行比较分析。结果微创组28例,常规组25例,进行至少4年的随访。微创组和常规组相比较,术中失血量少,早期VAS评分及ODI下降快,远期VAS评分及ODI无明显统计学差异。术后3个月微创组的T2弛豫时间显著低于常规组[(48±12)ms vs.(83±23)ms,P<0.000 01],术区周围的肌肉组织水肿消退早。但是微创组术中需要反复的透视[(103±27)s vs.(34±18)s,P<0.000 01],比常规组医护人员的射线暴露量增加。结论 Mast Quadrant通道和开放式经椎间孔腰椎融合术治疗腰椎间盘突出症的远期疗效相当,二者在长期VAS评分、ODI、二次手术率上无明显差异。不同的是,Mast Quadrant通道手术优点是术中失血量少、术后的疼痛缓解快,功能康复早,缺点是术中的透视时间长。这就需要我们在选择手术方式的过程中权衡利弊,采用合适的术式。
Objective To verify the effectiveness and safety of quadrant retractor surgery in long period, we conducted this randomized controlled study, which compared the quadrant retractor versus open surgery transforaminal lumbar interbody fusion（TLIF） for single level lumbar disc spondylosis patients. Methods From January 2009 to December 2010, 58 patients with single level lumbar disc spondylosis were enrolled and divided into two groups randomly. Then we followed up for at least 4 years. The outcome measures included the operation time, the volume of blood loss, Visual Analogue Scale, Oswestry disability index, T2 relax time of MRI and rate of re-operation. Results There were significant differences between the two treatment groups on the blood loss, early Visual Analogue Scale and Oswestry disability index, T2 relax time. There was no significant difference on late Visual Analogue Scale and Oswestry disability index, incidence of secondary surgery. Conclusion Quadrant retractor surgery and open surgery transforaminal lumbar interbody fusion are both effective in improving clinical status. Differently, the early Visual Analogue Scale and Oswestry disability index are relatively better preserved in Quadrant retractor surgery than open surgery. Quadrant retractor surgery is safe enough as an encouraging safe alternative to open TLIF surgery.
出处
《中华临床医师杂志（电子版）》
CAS
2016年第8期63-67,共5页
Chinese Journal of Clinicians(Electronic Edition)
