摘要
背景:腰椎滑脱常规修复方案创伤大、出血多,治疗后易遗留腰背痛。近年来脊柱生物力学的发展及新型脊柱内固定系统的研发及应用对于滑脱椎体的复位、融合有了新的认识。目的:观察Quadrant通道下微创经椎间孔入路修复腰椎滑脱患者1年随访的腰椎滑脱纠正情况及生物力学变化。方法:回顾性分析2012年6月至2013年9月收治的Quadrant通道下微创经椎间孔入路修复腰椎滑脱患者23例,观察治疗后3个月、1年患者Oswestry功能障碍指数、疼痛目测类比评分改善率,了解椎间融合情况及内固定有无松脱、断裂。结果与结论:所有患者顺利完成治疗,无脑脊液漏及神经损伤,治疗后1例患者切口感染、抗生素治疗10 d后感染控制,余患者切口均甲级愈合。所有患者均获得随访,治疗后3个月及1年随访时Oswestry功能障碍指数、疼痛目测类比评分均较治疗前明显恢复,差异有显著性意义(P<0.05),治疗后3个月及1年时Oswestry功能障碍指数、疼痛目测类比评分差异均无显著性意义(P>0.05),1年随访时Oswestry功能障碍指数改善率为(65.3±14.8)%,1年随访时疼痛目测类比评分改善率为(58.2±12.0)%。提示Quadrant通道下微创经椎间孔入路修复腰椎滑脱安全可行,不仅能有效的纠正腰椎滑脱畸形、维持脊柱的生物力学稳定、改善患者症状,还能降低治疗后患者腰背痛的发生率,获得较高的生活质量。
BACKGROUND： Conventional therapies for lumbar spondylolisthesis can result in trauma, bleeding and low back pain. With the vigorous development of spinal biomechanics and novel spinal fixation systems, we have more understanding on the reduction and fusion after spondylolisthesis. OBJECTIVE： To observe the clinical effects of transforaminal lumbar interbody fusion via the quadrant system On lumbar spondylolisthesis and related biomechanical changes. METHODS： A retrospective analysis was done in 23 patients with lumbar spondylolisthesis undergoing transforaminal lumbar interbody fusion via the quadrant system admitted from June 2012 to September 2013. Oswestry disability index and visual analog scale score were detected at 3 months and 1 year after treatment, as well as fusion conditions and internal fixation with or without loosening or breakage. RESULTS AND CONCLUSION： All patients were successfully treated, with no cerebrospinal fluid leakage and nerve injury. Incisions were healed well in all cases except one case suffered from incision infection that was controlled after 10 days of antibiotic treatment. All the patients were followed up. The Oswestry disability indexes and visual analog scale scores were significantly improved at 3 months and 1 year after treatment （P 〈 0.05）, but there was no difference in these two scores at 3 months and 1 year after treatment （P 〉 0.05）. The improvement rates of Oswestry disability index and visual analog scale score were （65.3±14.8）% and （58.2±12.0）%, respectively. These findings indicate that the transforaminal lumbar interbody fusion via the quadrant system is safe and effective to correct lumbar spondylolisthesis, maintains the biomechanical stability, improves patient＇s symptoms, reduces the incidence of low back pain and improves the quality of life.
出处
《中国组织工程研究》
CAS
北大核心
2015年第17期2699-2703,共5页
Chinese Journal of Tissue Engineering Research
