摘要
目的总结X-tube辅助下TLIF技术与局限性减压治疗椎管狭窄症的临床效果。方法采用X-tube辅助下多裂肌间隙入路部分椎板切除、经椎间孔入路腰椎椎体间融合、椎弓根螺钉固定治疗腰椎管狭窄症患者35例,单节段23例,双节段12例,年龄39～68岁,平均年龄53.6岁。35例患者中28例有效随访10～23个月,平均19个月。疗效评定症状改善率采用日本骨科学会(JOA)下腰痛评分标准,对患者手术前及手术后6周～12个月的疼痛程度进行评分。结果手术耗时单节段70～135 min,平均100 min;双节段120～210 min,平均150 min。术中出血单节段250～500 mL,平均300 mL;双节段350～800 mL,平均600 mL。28例随访患者中,症状改善率,优14例,良8例,一般2例,差2例,优良率达82%。椎间融合良好25例,另3例植骨融合欠佳,仍有较顽固下腰部疼痛,但较术前减轻。结论 X-tube辅助下TLIF技术与局限性加压治疗椎管狭窄症创伤小、并发症少,临床效果较好。
Objective To explore the feasibility and efficiency of treatment of lumbar spinal canal stenosis with limited laminectomy decompression, transforaminal lumbar interbody fusion （TLIF）under X-tube system for the management of lumbar spinal canal stenosis. Methods A total of 35 patients with lumbar spinal canal stenosis including 23 ones of single segment and 12 ones of two segments with an average age of 53.6 years ranging from 39 to 68 years,underwent limited laminectomy decompression and transforaminal lumbarinterbody fusion （TLIF） assisted by the X-tube system. We recorded the operate time,operate hemorrhage,the interverte-bralheight of preoperation and postoperation,the bone fusion rate,the change of JOA scoring and judged the effect. Results The operative duration,the single segment ones were 70 to 150 min（means 100 min） ,the two segments ones were 120 to 210 rain（means 150 min） ; the single segment ones ,the blood loss was 250 to 500 mL （means 300 mL）, the two segment ones, the blood loss was 350 to 800 mL（means 600 mL）.Total 28 patients were followed up from 7 to 23 months（means 16 months ） .The clinical effectswere excellent in 28, actor and good in 22 cases and fair in 2 cases, poor in 2 cases. 27 cases of them had showed remarkale bony interbody fusion on the X rays and CT, 3 of them was not good enough.The outcomes of operation was satisfied. Conclusion Limited laminectomy decompression, transforaminal lumbarinterbody fusion （TLIF） under X-tube system shows an excellentand good clinical outcome in the patients having spinal stenosis
出处
《中国现代医生》
2013年第20期39-41,44,共4页
China Modern Doctor
关键词
腰椎管狭窄
经椎间孔椎间融合
多裂肌间隙入路
局限性椎管减压
Lumbar spinal canal stenosis
Transforaminal lumbarinterbody fusion（TLIF）
Approach of muhifidus muscle gap（the approach of wihse）
Limited laminectomy decompression
