摘要
目的比较机器人辅助下微创与传统开放经椎间孔腰椎椎体间融合(TLIF)治疗腰椎退行性疾病的短期疗效。方法回顾性分析该院2018年1月至2019年1月收治的56例腰椎退行性疾病患者资料,根据手术方式分为微创组(26例)和对照组(30例)。微创组行机器人辅助下经皮微创TLIF治疗,对照组给予传统开放TLIF治疗。比较两组患者手术时间、术中出血量、术后引流量、引流时间、术后卧床时间及住院时间,手术透视剂量、透视时间、椎弓根螺钉置入精度、内倾角及螺钉与关节面的距离;以及术前、术后3 d和术后1、6、12个月患者腰痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分及相对椎间隙高度。结果患者平均随访时间为(12.7±1.3)个月。微创组术中出血量、术后引流量、引流时间、术后卧床时间及住院时间均明显小于对照组(P<0.05),手术时间明显长于对照组(P<0.05)。两组置钉精度分级无明显差异(P>0.05),微创组置钉的内倾角、螺钉与关节面的距离明显大于对照组(P<0.05)。两组手术前后相对椎间隙高度组间无明显差异(P>0.05),术后3 d微创组VAS和ODI评分明显低于对照组(P<0.05),术后其余各时间点VAS和ODI评分组间无明显差异(P>0.05)。结论机器人辅助微创手术治疗腰椎退变疾病可减少对肌肉和椎旁组织的损伤,减少术中出血与术后疼痛,达到快速康复的目标。
Objective To compare the short-term effects of robot-guided minimally invasive and traditional open transforaminal lumbar interbody fusion(TLIF)in the treatment of lumbar degenerative diseases.Methods The data of 56 patients with lumbar degenerative diseases admitted to this hospital from January 2018 to January 2019 were retrospectively analysed.According to the surgical method,the patients were divided into the minimally invasive group(n=26)and the control group(n=26).The minimally invasive group underwent robot-guided minimally invasive percutaneous TLIF treatment,and the control group received traditional open TLIF treatment.The operation time,intraoperative bleeding volume,postoperative drainage volume,drainage time,postoperative bedrest time and length of stay,surgical fluoroscopy dose,fluoroscopy time,pedicle screw insertion accuracy,convergence angle and the distance between screw and articular surface were compared between the two groups.The visual analogue scale(VAS)score,Oswestry dysfunction index(ODI)score and relative intervertebral space height before operation,at 3 days,1 month,6 months,12 months after operation were collected and compared between the two groups.Results The average follow-up time of patients was(12.7±1.3)months.The intraoperative bleeding volume,postoperative drainage volume,drainage time,postoperative bedrest time and length of stay in the minimally invasive group were significantly lower than those in the control group(P<0.05).However,the operation time in the minimally invasive group was significantly longer than that in the control group(P<0.05).There was no significant statistical difference in the screw placement accuracy between the two groups(P>0.05).The convergence angle and the distance between the screw and the articular surface in the minimally invasive group were significantly lager than those in the control group(P<0.05).There was no significant difference in the preoperative and postoperative relative intervertebral space height between the two groups(P>0.05).The VA
作者
林书
胡豇
万仑
唐六一
王跃
俞阳
张伟
LIN Shu;HU Jiang;WAN Lun;TANG Liuyi;WANG Yue;YU Yang;ZHANG Wei(Department of Orthopedics,Sichuan Academy of Medical Science/People′s Hospital of Sichuan Province,Chengdu,Sichuan 610072,China)
出处
《重庆医学》
CAS
2020年第22期3829-3834,共6页
Chongqing medicine
基金
四川省科技厅科技支撑项目(2019YFS0268)。
关键词
腰椎退行性疾病
机器人
微创外科手术
术中出血量
住院时间
lumbar degenerative diseases
robotics
minimally invasive surgical procedures
intraoperative bleeding volume
length of stay
