摘要
目的:评价腹腔镜辅助与小切口技术在前路腰椎间融合术中的应用价值。方法:1998年4月～2005年1月行L4/5前路腰椎间融合术52例,腹腔镜辅助下前路椎间融合手术23例(A组),其中男13例,女10例,平均年龄37.9±1.8岁;腰椎滑脱症14例,退变性椎间盘疾患4例,腰椎术后综合征5例。小切口经腹膜后前路椎间融合手术29例(B组),其中男16例,女13例,平均年龄37.4±1.6岁;腰椎滑脱症21例,退变性椎间盘疾患3例,腰椎术后综合征5例。对两组患者围手术期参数和并发症进行统计学分析比较。结果:A组与B组分别平均随访23.5个月和21.2个月,两组临床优良率、椎间高度维持和植骨融合率均无显著性差异(P>0.05),A组手术准备和操作时间明显长于B组(P<0.05),其住院时间、术中出血量与小切口组无统计学差异(P>0.05)。并发症:A组4例,发生率17.4%;B组3例,发生率10.3%,两组有显著性差异((P<0.05)。结论:应用腹腔镜辅助和小切口技术进行L4/5椎间融合都可以达到良好的临床治疗效果,但从并发症和技术上分析,采用小切口经腹膜后行L4/5椎间融合更为合理和微创,操作方便、快捷,不需特殊设备。
Objective：To evaluate the clinical effect of anterior lumbar spinal fusion by laparoscopic and mini-open technique.Method：Fifty-two patients were treated by anterior interbody fusion between April 1998 and January 2005,the involved level was L4/5.23 patients underwent laparoseopie （group A）,there were 13 males and 10 females with average age 37.9±1.8 years old.Lumbar spinal diseases including：spondylolisthesis in 14 cases,degenerative disc diseases in 4 cases and failure back surgery syndrome in 5 cases.29 patients underwent mini-open （group B）,there were 16 males and 13 females with average age 37.4±1.6 years old. Lumbar spinal diseases：spondylolisthesis in 21 cases,degenerative disc diseases in 3 cases and failure back surgery syndrome in 5 cases.Clinical researching data including general results,perioperative data and complications.χ2 and t test were used for statistical analysis.Result：The average follow-up time were 23.5 and 21.2 months in group A and B respectively,there were no statistical difference in clinical effect,interbody height and fusion between A and B （P〉0.05）.The operative preparation and procedure time by laparoscopic were more obviously longer than mini-open （P〈0.05）,there were no statistical difference in the hospital stay and intraoperative blooding loss by two technique （P〉0.05）.The operative complications：laparoscopic had 4 cases （17.4%） and mini-open 3 cases （10.3%）.The symptoms of back and leg pain were improved,there were no failure of fixation and the intervertebral beight were maintained.Conclusion：Both laparoscopic and mini-open techniques are effective approachs for anterior lumbar spinal fusion.According to the complications and techniques,mini-open procedure is a more reasonable,minimal invasive surgery technique.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第5期341-345,共5页
Chinese Journal of Spine and Spinal Cord
关键词
腰椎融合术
腹腔镜
小切口
前入路
Lumbar interbody fusion
Laparocopy
Mini-open technique
Anterior
