摘要
目的对微创经椎间孔腰椎椎体间融合(MIS-TLIF)下单纯椎间植骨融合与椎间Cage融合治疗单节段腰椎间盘突出症疗效的对比分析,以判断2种融合方法的术后疗效及对比临床价值。方法采用MIS-TLIF手术治疗的单节段腰椎间盘突出症患者共61例,根据融合方法的不同分为单纯椎间植骨融合组(A组)和椎间Cage融合组(B组)。比较两组患者的手术时间,术中出血量,术后引流量,临床疗效采用腰、腿疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分、日本骨科协会(JOA)评分和Macnab标准,行腰椎动力位X线片和CT三维重建检查评价椎间融合情况。结果两组患者性别、年龄、病程、病变节段等一般资料比较,差异均无统计学意义(P>0.05),具有可比性。两组患者术中出血量,术后引流量差异无统计学意义(P>0.05)。术后两组的VAS评分、ODI评分、JOA评分和Macnab标准,末次随访椎间融合率,差异无统计学意义(P>0.05)。两组患者的手术时间,手术后椎间隙高度变化,差异有统计学意义(P<0.05)。结论 MIS-TLIF下单纯植骨融合治疗腰椎间盘突出症可获得与Cage融合相当的临床疗效和植骨融合率,并且治疗费用低,无排斥反应,可供临床选择。
Objective To research the effect of pure interbody fusion and interbody cage fusion under minimally invasive transforaminal lumbar interbody fusion treat to single segment of lumbar disc herniation,analysis clinical value the two methods. Methods A total of 61 cases single segment lumbar disc herniation were treated with MIS-TLIF surgery,were divided into pure interbody fusion group （group A） and interbody fusion Cage group （group B） according to different fusion methods. Operative time, blood loss and postoperative drainage were recorded in two groups, the clinical efficacy were tested by using of visual analogue score （VAS） ,Japanese Orthopedic Association scores （JOA）, Oswestry disability index （ODI） score and Macnab standard, the interbody fusion ability were evaluated by power lumbar X-ray film and CT 3D reconstruction. Results The gender,age,disease duration and disease segments in two gracps were not found statistically significant difference （P〉0.05）. Also, two groups of patients, blood loss, postoperative drainage has no significant difference （P〉0.05）. After the operation, the VAS score, ODI score,JOA score and Macnab criteria,the last follow-up of intervertebral fusion rate in in tuo groups were not found statistically significant difference （P〉0.05）. While the operative time,postoperative disc height changes were found significant difference between two groups（P〈 0.05）. Conclusion MIS-TLIF simple fusion for lumbar disc herniation will be available with equal clinical efficacy fusion rate compared with cage fusion.
出处
《重庆医学》
CAS
北大核心
2017年第8期1048-1051,共4页
Chongqing medicine
基金
承德市科学技术研究与发展计划(20142045)
