摘要
目的:观察微创经椎间孔入路椎间融合术(MIS-TLIF)治疗老年退行性腰椎管狭窄症(DLSS)患者的效果。方法:回顾性分析2019年10月至2022年1月该院收治的67例老年DLSS患者的临床资料,根据手术方法不同将其分为观察组(n=35)和对照组(n=32)。观察组采用MIS-TLIF治疗,对照组采用开放经椎间孔融合术(O-TLIF)治疗。比较两组手术相关指标(手术时间、术后首次下床活动时间、术后住院时间、术中透视次数、术中出血量、引流量)水平,手术前后炎性因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)]、影像学参数(伤椎Cobb角、腰椎前突角)水平,以及并发症发生率。结果:观察组手术时间长于对照组,术后首次下床活动时间、术后住院时间均短于对照组,术中透视次数多于对照组,术中出血量和引流量均少于对照组,差异有统计学意义(P<0.05);术后1 d,两组血清IL-6、PCT、CRP水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后6个月,两组腰椎前突角均大于术前,伤椎Cobb角均小于术前,但组间比较,差异均无统计学意义(P>0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:MIS-TLIF治疗DLSS患者可缩短术后首次下床活动时间和术后住院时间,减少术中出血量和引流量,降低炎性因子水平的效果优于O-TLIF治疗,但需延长手术时间和增加术中透视次数。
Objective:To observe effects of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)in treatment of elderly patients with degenerative lumbar spinal stenosis(DLSS).Methods:The clinical data of 67 elderly patients with DLSS admitted to the hospital from October 2019 to January 2022 were retrospectively analyzed.According to different surgical methods,they were divided into observation group(n=35)and control group(n=32).The observation group was treated with MIS-TLIF,while the control group was treated with open transforaminal fusion(O-TLIF).The levels of operation-related indicators(operation time,first out-of-bed time after the surgery,postoperative hospitalization time,number of intraoperativefluoroscopy,intraoperative blood loss,and drainage volume),the levels of inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6)]and the imaging parameters(Cobb angle of injured vertebrae,lumbar lordosis angle)before and after the surgery,and the incidence of complications were compared between the two group.Results:The operation time of the observation group was longer than that of the control group,thefirst out-of-bed time after the surgery and the hospitalization time were shorter than those of the control group,the number of intraoperativefluoroscopy was more than that of the control group,the intraoperative blood loss and drainage volume were less than those of the control group,and the differences were statistically significant(P<0.05).1 day after the surgery,the levels of serum IL-6,PCT and CRP in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).6 months after the surgery,the lumbar lordosis angle of the two groups were larger than those before the surgery,and the Cobb angle of the injured vertebrae were smaller than those before the surgery,but there were no significant differences between the two groups(P>0.05).There was no signif
作者
宋磊磊
SONG Leilei(Department of Orthopaedics of Nanyang Central Hospital,Nanyang 473000 Henan,China)
出处
《中国民康医学》
2024年第15期59-62,共4页
Medical Journal of Chinese People’s Health
关键词
腰椎管狭窄症
老年
椎间融合术
经椎间孔入路
炎性因子
伤椎Cobb角
腰椎前突角
Lumbar spinal stenosis
Elderly
Interbody fusion
Transforaminal approach
Inflammatory factor
Cobb angle of injured vertebra
Lumbar lordosis angle
