摘要
目的研究腰椎疾病患者实施经皮可扩张通道辅助下微创经椎间孔入路椎间融合手术治疗退行性腰椎滑脱的(Minimally Invasive Spine Surgery-Transforaminal Lumbar Interbody Fusion,MISS-TLIF)临床实效性。方法方便选择74例于该院退行性腰椎滑脱症患者,纳入时间为2016年4月—2017年4月,采用随机数字表法将其分为实验组与对照组,每组均37例。其中对照组采用常规传统开放经后路椎间融合术(Traditional Open Posterior Lumbar Interbody Fusion,TO-PLIF),实验组行MISS-TLIF手术,对比两组患者手术相关指标(包括手术时长、切口长度、出血量、引流量、住院时长),围手术期相关评分[包括术前、术后3个月及术后1年的视觉疼痛模拟评分(Visual analogue scale,VAS)、JOA下腰痛评分(Japanese Orthopaedic Association Score,JOAS)、Oswestry伤残指数(Oswestry Disability Index,ODI)],以及临床手术疗效。结果实验组手术时长(197.94±18.46)min、住院时长(8.71±1.59)d均短于对照组,与对照组相比,实验组出血量(209.41±9.45)mL、引流量(39.71±7.77)mL较少、切口长度(4.22±0.96)cm较短(t=0.374 5,12.471 7,53.291 5,18.637 7,16.190 8,P<0.05);实验组术前视觉疼痛模拟评分(6.35±1.74)分、术后1年视觉疼痛模拟评分(1.96±0.92)分、术前JOA下腰痛评分(10.54±1.44)分、术后1年JOA下腰痛评分(27.28±1.15)分、术前Oswestry伤残指数(60.05±3.83)分、术后1年Oswestry伤残指数(13.54±3.50)分与对照组相比均差异无统计学意义(t=0.201 1,0.551 9,0.274 4,0.721 9,1.248 3,1.314 0,P>0.05);实验组术后3个月实验组视觉疼痛模拟评分(2.24±1.3)分、JOA下腰痛评分(17.84±1.97)分、Oswestry伤残指数(18.05±3.25)分均低于对照组(t=4.912 1,12.167 8,5.064 8,P<0.05);实验组退行性腰椎滑脱症临床手术植骨融合比例(94.59%)明显高于对照组(70.27%),两者差异有统计学意义(χ^2=7.558 6,P<0.05)。结论退行性腰椎滑脱应用MISS-TLIF手术方式效果优于常规开放椎�
Objective To study the minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar spondylolisthesis (Minimally Invasive Spine Surgery-Transforaminal Lumbar Interbody Fusion, MISS-TLIF) clinical effectiveness. Methods Seventy-four patients with degenerative lumbar spondylolisthesis were enrolled in our hospital. The enrollment time was convenient from April 2016 to April 2017. The patients were divided into experimental group and control group by random number table, with 37 cases in each group. The control group was treated with conventional Traditional Open Posterior Lumbar Interbody Fusion (TO-PLIF), and the experimental group underwent MISS-TLIF. The surgical outcomes (including duration of surgery, length of incision, and length of the incision were compared between the two groups). Perioperative blood pressure, drainage volume, length of hospital stay, perioperative-related scores [including visual analogue scale (VAS), JOA lower back pain score (Japanese Orthopaedic Association Score, JOAS) Oswestry Disability Index (ODI), and clinical surgical outcomes before surgery, 3 months after surgery, and 1 year after surgery. Results The length of operation in the experimental group (197.94±18.46)min and the length of hospital stay (8.71±1.59)d were shorter than those in the control group. Compared with the control group, the amount of bleeding in the experimental group (209.41±9.45)mL, the drainage volume(39.71±7.77)mL was less, and the length of the incision (4.22±0.96)cm was shorter (t=0.3745, 12.471 7, 53.291 5, 18.637 7, 16.190 8, P<0.05);preoperative visual pain simulation in the experimental group of (6.35±1.74) points, 1 year postoperative visual pain simulation score (1.96±0.92)points, preoperative JOA lower back pain score (10.54±1.44) points, 1 year postoperative JOA lower back pain score (27.28±1.15)points, preoperative Oswestry disability index (60.05±3.83) points, 1 year postoperative Oswestry disability index(13.54±3.50)points were not significantly
作者
朱恩崇
胡泽东
周永华
徐辉
梁建
ZHU En-chong;HU Ze-dong;ZHOU Yong-hua;XU Hui;LIANG Jian(Department of Orthopaedics,Yunnan Kunming Iron and Steel Hospital,Kunming,Yunnan Province,650302 China)
出处
《中外医疗》
2019年第14期44-47,共4页
China & Foreign Medical Treatment
