摘要
目的:分析Quadrant通道下腰椎微创融合术治疗腰椎退行性疾病的的疗效及安全性。方法:选取2016年11月至2019年11月收治的86例腰椎退行性疾病患者为研究对象,均采用Quadrant通道下腰椎微创融合治疗,观察并记录手术时间、术中出血量、术后下地活动时间、疼痛程度VAS评分、Oswestry功能障碍指数(ODI)、腰椎功能JOA评分、椎间隙腹侧高度、椎间隙背侧高度、椎间隙手术侧高度、体椎间融合率、邻近椎间盘退变发生率、炎性因子(C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10))及并发症发生率,并对患者进行1 a随访,记录远期效果。结果:Quadrant通道下腰椎微创融合治疗腰椎退行性疾病的手术时间为(128.23±20.67)min,术中出血量为(188.23±15.19)mL,术后下地活动时间为(3.07±0.53)d。治疗后3个月,腰椎退行性疾病患者VAS评分为(1.35±0.33)分,JOA评分为(20.16±6.15)分,ODI评分为(12.19±3.55)分;治疗后椎间隙腹侧高度为(18.41±6.03)mm,椎间隙背侧高度为(12.68±5.19)mm,椎间隙手术侧高度为(13.67±5.12)mm;治疗后血清CRP为(14.38±3.62)mg/L,TNF-α为(30.65±10.19)pg/mL,IL-6为(14.45±5.28)pg/mL,IL-10为(8.11±2.04)ng/mL;治疗后VAS、ODI评分低于治疗前,JOA评分、血清炎性因子水平和椎间隙腹侧、背侧及手术侧高度均高于治疗前,差异有统计学意义(P<0.05)。椎体间融合率为95.35%,邻近椎间盘退变发生率为22.09%,并发症发生率为4.65%。术后1 a复查腰椎MRI显示,观察组保护节段的椎间盘突出均消失;未发现邻近节段不稳;无邻近节段退变性疾病发生。结论:Quadrant通道下腰椎微创融合治疗腰椎退行性疾病的疗效显著,可缓解疼痛程度,提高腰椎功能,降低炎性因子水平,且安全性较高,远期疗效更佳。
Objective:To analyze the efficacy and safety of Quadrant channel minimally invasive lumbar fusion in the treatment of degenerative diseases of the lumbar spine.Methods:86 patients with lumbar degenerative diseases from November 2016 to November 2019 were selected as the research objects, and all of them were treated with minimally invasive lumbar fusion through Quadrant channel.The operation time, intraoperative blood loss, postoperative ambulation time, VAS score, Oswestry disability index(ODI),lumbar spine function JOA score, intervertebral space ventral height, intervertebral space dorsal height, intervertebral space operative side height, intervertebral fusion rate, adjacent intervertebral disc degeneration rate, inflammatory factors(C-reactive protein(CRP) tumor necrosis factor-α(TNF-α)、interleukin-6(IL-6),interleukin-10(IL-10)) and the incidence of complications were documented.Results:The operation time of minimally invasive lumbar fusion in the treatment of lumbar degenerative diseases through Quadrant channel was(128.23±20.67) min, intraoperative blood loss was(188.23±15.19) mL,postoperative ambulation time was(3.07±0.53)d.At 3 months after treatment, the VAS score, JOA score and ODI score of patients with lumbar degenerative disease were(1.35±0.33),(20.16±6.15) and(12.19±3.55) respectively.After treatment, the ventral height of the intervertebral space was(18.41±6.03) mm, the dorsal height of the intervertebral space was(12.68±5.19) mm, and the operating height of the intervertebral space was(13.67±5.12) mm.After treatment, serum CRP,TNF-α,IL-6 and IL-10 were(14.38±3.62) mg/L,(30.65±10.19) pg/mL,(14.45±5.28) pg/mL,and(8.11±2.04) ng/mL.After treatment, VAS and ODI scores were lower than before treatment, while JOA score, serum inflammatory factor level and ventral, dorsal and surgical height of intervertebral space were higher than those before treatment(P<0.05).The intervertebral fusion rate was 95.35%,the incidence of degeneration of adjacent intervertebral discs was 22.09%,and the in
作者
孟超
章玉冰
李勇
郑军
MENG Chao;ZHANG Yubing;LI Yong;ZHENG Jun(Department of Spine Surgery,Anhui Second People’s Hospital,Hefei 230032,China)
出处
《中国中医骨伤科杂志》
CAS
2021年第10期47-50,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
