摘要
目的：探讨微创经椎间孔腰椎体间融合术（ MIS-TLIF）治疗复发性腰椎间盘突出症（ RLDH）的临床疗效。方法对20例RLDH患者行MIS-TLIF治疗,其中L4∽512例、L5∽S18例。采用单侧微创通道下和双侧椎弓根螺钉内固定术,记录手术时间、术中出血量、术后引流量、术后下地时间、术后住院天数采用VAS评分和ODI评估手术疗效。结果1例患者术中出现硬脊膜撕裂,其余患者均顺利完成手术。手术时间80∽140（104．7±14．9）min,术中出血量60∽420（202．5±86．7）ml,术后引流量60∽160（93．2±29．6）ml,术后下地时间20∽48（34．3±8．3）h,术后住院天数3∽7（4．8±1．2）d。20例患者均获随访,时间12∽24（17．0±3．6）个月。术后5 d、3个月、1年的腰、腿痛VAS评分和ODI与术前比较均明显改善,差异有统计学意义（P〈0．05）。结论 MIS-TLIF具有创伤小、出血少等优点,是治疗RLDH安全有效的方法。
Objective To investigate the clinical outcome of minimally invasive transforaminal lumbar interbody fusion （MIS-TLIF） for recurrent lumbar disc herniation （RLDH） under microscope. Methods 20 cases suffering from RLDH were retrospectively treated by MIS-TLIF （ including L4∽5 in 12 cases, L5 ∽S1 in 8 cases） . Operative time, the intraoperative blood loss, the postoperative drainage, the postoperative ambulation time, the hospitalization time were recorded. VAS scores and ODI were used to evaluate the clinical outcomes. Results Only one patient had du-ral laceration during the operation and no leakage of cerebrospinal fluid or nerve injury was noted for the rest patients. The operative time was range 80∽140 （ 104. 7 ± 14. 9 ） min, the operative blood loss was range 60 ∽420 （ 202. 5 ± 86. 7） ml,the postoperative drainage volume was 60∽160（93. 2 ± 29. 6）ml, the postoperative ambulation time was range 20∽48 （34.3 ±8.3） h, and the hospitalization time was range 3∽7（4.8 ±1.2）d. The follow-up time was range 12∽24（17. 0 ± 3. 6）months. Postoperative 5 days,3months,1year, pain VAS of lumbar and legs and ODI scores were significantly improved compared with the preoperative, the difference was statistically significant （ P 〈0. 05）. Conclusions MIS-TLIF is a safe and effective procedure for treatment of RLDH, which has less invasion and less bleeding.
出处
《临床骨科杂志》
2015年第4期406-409,共4页
Journal of Clinical Orthopaedics
基金
2013安徽省年度重点科研项目(编号:1301043029)
关键词
复发性腰椎间盘突出症
外科手术
微创性
经椎间孔腰椎体间融合术
recurrent lumbar disc herniation
surgical procedures,minimally invasive
transforaminal lumbar inter-body fusion
