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轩安武,谢雁春,张猛,李卓,赵阳阳,于海龙*.微创经椎间孔入路与极外侧入路腰椎椎间融合术治疗短节段腰椎退行性疾病的近期疗效比较[J].脊柱外科杂志,2019,17(2):84-89.
微创经椎间孔入路与极外侧入路腰椎椎间融合术治疗短节段腰椎退行性疾病的近期疗效比较     点此下载全文 (Fulltext)
轩安武  谢雁春  张猛  李卓  赵阳阳  于海龙*
中国人民解放军北部战区总医院骨科, 沈阳 110016
基金项目:
DOI:10.3969/j.issn.1672-2957.2019.02.003
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摘要:
      目的 比较微创经椎间孔入路腰椎椎间融合术(MIS-TLIF)与极外侧入路腰椎椎间融合术(XLIF)治疗退行性腰椎滑脱合并腰椎椎管狭窄的近期疗效。方法 回顾性分析2013年3月-2014年6月收治的75例腰椎退行性疾病且行微创手术治疗患者的临床资料,其中36例选择行MIS-TLIF,39例选择行XLIF。记录2组患者手术时间、术中出血量,分析随访2年期间患者下肢痛和腰痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)、生活质量评价量表(SF-36)评分和患者对手术的满意度。结果 MIS-TLIF组和XLIF组中位手术时间分别为169 min和182 min,差异无统计学意义(P>0.05);MIS-TLIF组术中出血量为(90±20)mL,XLIF组术中出血量为(50±10)mL,差异有统计学意义(P<0.05)。随访2年,所有患者下肢痛和腰痛VAS评分、ODI和SF-36评分均较术前明显改善,差异有统计学意义(P<0.05),但组间比较差异均无统计学意义(P>0.05)。结论 MIS-TLIF与XLIF虽然减压机制不同,但随访2年的术后疗效无明显差异,2种微创方法均可有效治疗腰椎退行性疾病。
关键词:腰椎  脊椎滑脱  椎管狭窄  外科手术,微创性  脊柱融合术
Comparison of short-term outcomes between minimally invasive transforaminal and extreme lateral lumbar interbody fusion for short-segment lumbar degenerative diseases    Fulltext
XUAN An-wu  XIE Yan-chun  ZHANG Meng  LI Zhuo  ZHAO Yang-yang  YU Hai-long*
Department of Orthopaedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang 110016, Liaoning, China
Fund Project:
Abstract:
      Objective To compare the short-term efficacy of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and extreme lateral approach lumbar interbody fusion(XLIF) for degenerative spondylolisthesis with lumbar spinal stenosis. Methods From March 2013 to June 2014, clinical data of 75 patients with degenerative lumbar diseases treated by minimally invasive surgery were retrospectively analyzed. Thirty-six patients underwent MIS-TLIF and 39 underwent XLIF. The operation time and intraoperative blood loss were recorded, and the visual analogue scale (VAS) scores of low back and lower limb pain, Oswestry disability index (ODI), quality of life score (SF-36) and satisfaction during 2-year follow-up were analyzed. Results The median operation time of MIS-TLIF group and XLIF group was 169 min and 182 min respectively, with no significant difference (P>0.05). The intraoperative blood loss in MIS-TLIF group was (90±20)mL, and that in XLIF group was (50±10)mL, with a significant difference (P<0.05). During 2-year follow-up, all the patients were significantly improved than pre-operation in low back and lower limb pain VAS scores, ODI and quality-of-life(SF-36) score, all with significant differences(P<0.05); and the differences between the 2 groups were not significant(P>0.05). Conclusion Although the decompression mechanisms between MIS-TLIF and XLIF are different, there is no significant difference in the efficacy of 2-year follow-up, suggesting MIS-TLIF and XLIF can both be used as effective and minimally invasive treatment for lumbar degenerative diseases.
Keywords:Lumbar vertebrae  Spondylolysis  Spinal stenosis  Surgical procedures, minimally invasive  Spinal fusion
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