摘要
[目的]基于动物随机对照实验及临床病例应用,研究横突间入路胸椎椎体间融合术(ITIF)的可行性、安全性与有效性。[方法]将24只成年山羊,体重(35.67±2.39)kg,随机分为横突间入路胸椎椎体间融合术组(ITIF组)、经椎间孔胸椎椎体间融合术组(TTIF组)、ITIF加椎弓根固定组(IFIFPS组)、TTIF加椎弓根固定组(TTIFPS组),每组6只。比较四组动物手术过程所需时间、术中出血量,术后第12周拍摄X线及CT,比较术后12周植骨融合情况。并报道临床病例1例。[结果]ITIF组在手术时间、出血量方面均少于TTIF组,差异有统计学意义(P<0.05)。12周时四组动物均出现融合情况,骨性融合不完全,骨小梁排列不够整齐,融合率虽有高低,但手术方式与融合率之间差异无统计学意义(P>0.05)。对1例强直性脊柱炎骨折患者行T10/11横突间入路椎体间自体髂骨植骨融合T8~L1内固定术,手术顺利,术后3年复查,见T10/T11椎体间骨性融合,患者无疼痛等不适症状。[结论]横突间入路胸椎椎体间融合术(ITIF)与经椎间孔胸椎椎体间融合术(TTIF)相比,可明显减少手术时间、术中出血量,具有良好的可行性、安全性。
[Objective]To study the feasibility,safety and efficacy of intertransverse thoracic interbody fusion(ITIF)through transverse approach by a randomized con trolled animal experiment and primary clinical application.[Methods]Twenty-four adult goats weighted of(35.67±2.39)kg were randomly divided into the ITIF group,transforaminal tho racic interbody fusion(TTIF)group,ITIF combined with pedicle screw(ITIFPS)group and TTIF combined with pedicle screw(TTIFPS)group,with 6 animals in each group.The operation parameters,including operation time and intraoperative blood loss,and imaging examinations,such as X-ray and CT taken at the 12th week after the operation were compared among 4 groups.In addition,it was reported that the ITIFPS performed in a patient who suffered from thoracic fracture secondary to ankylosing spondylitis.[Results]There were significant differences regarding to operation time and intraoperative blood loss among the 4 groups(P<0.05).Correspondingly,the ITIF group consumed significantly less operation time,associated with significantly less blood loss than the TTIF group(P<0.05),whereas the ITIFPS group has significantly shorter operation time and less blood loss than the TTIFPS group(P<0.05).At 12 weeks after operation,interbody fusion was revealed on images regardless of imperfect union with irregular trabecula arrangement and low fusion rates,and there was no a significant difference in fusion rate among the 4 groups.With respect to clinical setting,a patient received successful T10/11 intertransverse thoracic interbody fusion for tho racic fracture subsequent to ankylosing spondylitis,and had no discomfort with solid bony fusion of T10/11 intervertebral space.[Conclusion]Compared with transforaminal thoracic interbody fusion(TTIF),this intertransverse thoracic interbody fusion(ITIF)significantly reduces the operation time and intraoperative bleeding,and might have good feasibility,safety and efficien cy in clinical setting.
作者
贾梦龙
李念虎
徐展望
孔鹏
姜平
岳晨
任亮
JIA Meng-long;LI Nian-hu;XU Zhan-wang;KONG Peng;JIANG Ping;YUE Chen;RAN Liang(Shandong University of Traditional Chinese Medicine,Jinan 250014,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2020年第6期531-536,共6页
Orthopedic Journal of China
基金
山东大学科技计划项目(编号:201401261)
山东省高等学校科技计划项目(编号:J17KA242)
国家自然科学基金项目(编号:81473709)
第六批全国老中医药专家学术经验继承工作项目(批文号:国中医药人发[2017]29号)
徐展望山东省名老中医药专家传承工作室建设项目(批文号:山东省卫生健康委员会鲁卫函[2019]92号)。
关键词
动物实验
下胸椎
横突间入路
椎间融合
animal experiment
lower thoracic vertebrae
intertransverse approach
interbody fusion
