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陈斌彬,毛克亚,韩振川,刘建恒,张雅宾.微创经椎间孔入路腰椎椎间融合术治疗腰椎滑脱症的中短期随访[J].脊柱外科杂志,2019,17(5):297-302.
微创经椎间孔入路腰椎椎间融合术治疗腰椎滑脱症的中短期随访     点此下载全文 (Fulltext)
陈斌彬1  毛克亚1*  韩振川1  刘建恒1  张雅宾2
1. 解放军总医院第一医学中心骨科, 北京 100853;
2. 解放军总医院第二医学中心骨科, 北京 100853
基金项目:国家自然科学基金面上项目(51772328,81702121);首都卫生发展科研专项项目(首发2018-4-5014);军队后勤重大项目子课题(AWS17J004);解放军总医院临床科研扶持基金(2017FC-TSYS-2006)
DOI:10.3969/j.issn.1672-2957.2019.05.001
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摘要:
      目的 对比微创经椎间孔入路腰椎椎间融合术(MIS-TLIF)与传统开放后路腰椎椎间融合术(PLIF)治疗单节段腰椎滑脱症的中短期疗效,以评价MIS-TLIF的安全性。方法 回顾性分析2015年3月-2017年9月166例单节段腰椎滑脱症患者临床资料,70例行MIS-TLIF治疗,96例行PLIF治疗。比较2组患者围手术期指标、疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)与术后并发症发生情况。结果 MIS-TLIF组术中出血量、术后引流量、切口长度、术后卧床天数、术后住院天数、住院费用和手术满意度均优于PLIF组,差异有统计学意义(P<0.05);但MIS-TLIF组术后血清肌酸激酶值显著高于PLIF组,差异有统计学意义(P<0.05);2组手术时间,手术前后VAS评分、ODI,并发症发生率和椎间融合率差异均无统计学意义(P>0.05)。结论 MIS-TLIF治疗腰椎滑脱症,疗效确切,安全性好,术后恢复快,住院费用低,手术满意度高;但MIS-TLIF术后血清肌酸激酶值偏高,考虑可能因术中使用电刀,通道空间狭小,术中吸引器使用少,肌酸激酶大量吸收入血所致,仍需进一步研究证实。
关键词:腰椎  脊椎滑脱  脊柱融合术  外科手术,微创性
Medium-and short-term follow-up study on treatment of lumbar spondylolisthesis by minimally invasive transforaminal lumbar interbody fusion    Fulltext
CHEN Bin-bin1  MAO Ke-ya1*  HAN Zhen-chuan1  LIU Jian-heng1  ZHANG Ya-bin2
1. Department of Orthopaedics, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China;
2. Department of Orthopaedics, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Fund Project:
Abstract:
      Objective To compare the short-term and medium-term effects of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and traditional posterior lumbar interbody fusion (PLIF) in the treatment of single-segment lumbar spondylolisthesis, and to evaluate the safety of MIS-TLIF. Methods Clinical data of 166 patients with single-segment lumbar spondylolisthesis from March 2015 to September 2017 were retrospectively analyzed, of whom 70 were treated with MIS-TLIF and 96 with PLIF. Perioperative indicators, visual analogue scale (VAS)score, Oswestry disability index (ODI) and postoperative complications were compared between the 2 groups. Results MIS-TLIF group was superior to PLIF group in intraoperative blood loss, postoperative drainage, incision length, postoperative bed-rest time, postoperative hospitalization stay, hospitalization costs and surgical satisfaction, with statistically significant differences(P<0.05); However, the serum creatine kinase level in MIS-TLIF group was significantly higher than that in PLIF group, with statistically significant difference(P<0.05). There was no significant difference in operation time, VAS score, ODI, complication rate and intervertebral fusion rate between the 2 groups(P>0.05). Conclusion MIS-TLIF is effective and safe in the treatment of lumbar spondylolisthesis, with fast recovery, low cost and high surgical satisfaction. However, the high serum creatine kinase value after MIS-TLIF may be due to the use of electric knife during operation, narrow channel space, less use of intraoperative attractors, and large absorption of creatine kinase into blood. The further studies are still needed to confirm this.
Keywords:Lumbar vertebrae  Spondylolysis  Spinal fusion  Surgical procedures, minimally invasive
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