双侧TLIF技术治疗腰椎滑脱症
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摘要
目的:探讨双侧经椎间孔椎间融合术(TLIF)技术治疗腰椎节段性滑脱的临床疗效及手术经验。方法:选择2013年6月~2015年11月67例腰椎滑脱患者,行双侧TLIF减压与钉棒内固定术,并进行分析。评价标准:视觉模拟评价法(VAS),功能障碍指数(ODI)评分,影像学观察滑脱角、椎间隙高度、椎体滑移距离及手术用时、出血量、并发症情况。结果:所有患者均顺利完成手术,随访3~11个月,2例拒绝接受随访,2例随访中失去联系。滑脱角、椎体滑移距离、椎间隙高度均恢复良好,融合情况可。VAS评分:术前(8.59±0.91)分,术后1周(1.62±0.79)分,末次随访(1.09±0.49)分;ODI评分:术前(48.6±5.6)分,术后1周(13.5±2.3)分,末次随访(11.8±2.6)分。手术前后差异具有统计学意义(P<0.05)。结论:双侧TLIF对腰椎滑脱的治疗效果明显,对于恢复腰椎的稳定、缓解疼痛、功能改善是安全、可行、有效的。
Objective: To investigate the clinical efficacy and surgical experience of bilateral TLIF technique treatment of lumbar spondylolisthesis. Method: From June 2013 to November 2015, 67 patients with lumbar spondylolisthesis were selected, treated by bilateral TLIF technique compression and screw rod fixation and analyzed. Evaluation criteria: Visual Analogue Scale(VAS), Oswestry Disability Index(ODI), imaging observation slip angle, height of intervertebral disc, vertebral slip distance, and the operation time, blood loss, complications. Results: All patients were successfully completed surgery and were followed up for 3~11 months, 2 patients refused follow-up, and 2 patients lost contact during the follow-up. The slip angle, vertebral slip distance, and the height of intervertebral disc were all recovered well, and the VAS score was: preoperative(8.59±0.91), 1 week after surgery(1.62±0.79), the final follow-up(1.09±0.49); the ODI score: preoperative(48.6 ±5.6), 1 week after surgery(13.5 ±2.3), final follow-up(11.8 ±2.6). The difference was statistically significant(P<0.05). Conclusion: The bilateral TLIF has obvious therapeutic effect on lumbar spondylolisthesis, and it is safe,feasible and effective for recovering the stability of lumbar vertebra and relieving pain and function.
Objective: To investigate the clinical efficacy and surgical experience of bilateral TLIF technique treatment of lumbar spondylolisthesis. Method: From June 2013 to November 2015, 67 patients with lumbar spondylolisthesis were selected, treated by bilateral TLIF technique compression and screw rod fixation and analyzed. Evaluation criteria: Visual Analogue Scale(VAS), Oswestry Disability Index(ODI), imaging observation slip angle, height of intervertebral disc, vertebral slip distance, and the operation time, blood loss, complications. Results: All patients were successfully completed surgery and were followed up for 3~11 months, 2 patients refused follow-up, and 2 patients lost contact during the follow-up. The slip angle, vertebral slip distance, and the height of intervertebral disc were all recovered well, and the VAS score was: preoperative(8.59±0.91), 1 week after surgery(1.62±0.79), the final follow-up(1.09±0.49); the ODI score: preoperative(48.6 ±5.6), 1 week after surgery(13.5 ±2.3), final follow-up(11.8 ±2.6). The difference was statistically significant(P<0.05). Conclusion: The bilateral TLIF has obvious therapeutic effect on lumbar spondylolisthesis, and it is safe,feasible and effective for recovering the stability of lumbar vertebra and relieving pain and function.
引文
[1]王翀,方明桥,项光恒,等.单侧与双侧椎弓根螺钉固定联合经椎间孔椎间融合术治疗腰椎退行性疾病的长期疗效比较[J].中国脊柱脊髓杂志,2014,24(9):795-801
[2]邢永军,邢少华,刘增亮.TLIF与PLIF治疗中重度腰椎滑脱症的疗效比较[J].河北医学,2015,21(8):1432-1435
[3]马远征,李大伟.腰椎滑脱与腰椎不稳的诊疗[J].中国骨伤,2014,27(9):709-711
[4]陈子贤,梁运,蒋淳,等.单侧椎弓根螺钉固定TLIF术治疗老年退行性腰椎滑脱的疗效分析[J].老年医学与保健,2015,21(2):104-108
[5]张惠,肖龙,张建伟,等.经椎间孔腰椎间融合术治疗腰椎不稳的疗效[J].江苏医药,2014,40(11):1295-1297
[6]张思萌,李忠海,孙天胜.成人峡部裂型腰椎滑脱症的手术治疗[J].中国骨与关节杂志,2014,26(1):10-14
[2]邢永军,邢少华,刘增亮.TLIF与PLIF治疗中重度腰椎滑脱症的疗效比较[J].河北医学,2015,21(8):1432-1435
[3]马远征,李大伟.腰椎滑脱与腰椎不稳的诊疗[J].中国骨伤,2014,27(9):709-711
[4]陈子贤,梁运,蒋淳,等.单侧椎弓根螺钉固定TLIF术治疗老年退行性腰椎滑脱的疗效分析[J].老年医学与保健,2015,21(2):104-108
[5]张惠,肖龙,张建伟,等.经椎间孔腰椎间融合术治疗腰椎不稳的疗效[J].江苏医药,2014,40(11):1295-1297
[6]张思萌,李忠海,孙天胜.成人峡部裂型腰椎滑脱症的手术治疗[J].中国骨与关节杂志,2014,26(1):10-14
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