摘要
目的:探讨椎旁肌间隙(Wiltse)入路单侧经椎间孔椎体间融合术(TLIF)对极外侧型腰椎间盘突出症(FLLDH)患者术后疼痛程度及腰椎功能的影响。方法:选取某院64例FLLDH患者,依照随机抽签法将其分为2组,每组32例。对照组接受传统后正中入路TLIF治疗,观察组接受Wiltse入路单侧TLIF治疗,比较2组患者手术相关指标及术后腰椎功能、疼痛程度、应急反应情况。结果:观察组手术时长、术中失血量、术后引流量均少于对照组(P<0.05);术后3个月、1年,观察组Oswestry功能障碍指数(ODI)评分低于对照组(P<0.05);术后3d,观察组血清β-内啡肽(β-EP)高于对照组,前列腺素E2(PGE2)、神经肽Y(NPY)、血清皮质醇(Cor)、丙二醛(MAD)、超氧阴离子(O2-)、氢氧根离子(OH-)均低于对照组(P<0.05)。结论:Wiltse入路单侧TLIF治疗FLLDH,不仅能缩短手术时长,减少术中失血量、术后引流量,减少疼痛,还能改善患者腰椎功能,且对应激反应影响小。
Objective:To analyze the effect of unilateral transforaminal lumbar interbody fusion(TLIF)via the paravertebral muscle space(WILTSE)approach on postoperative pain and lumbar function in patients with far lateral lumbar disc herniation(FLLDH).Methods:64 patients with FLLDH were selected and randomly divided into two groups,with 32 cases in each group.The control group was treated with traditional posterior median approach TLIF,and the observation group was treated with Wiltse approach unilateral TLIF.The therapeutic effects of the two groups were compared.Results:(1)Surgical indicators:the duration of operation in the observation group was shorter than that in the control group,and the amount of intraoperative blood loss and postoperative drainage volume were less than those in the control group(P<0.05).(2)Lumbar function:3 months and 1 year after the surgery,the Oswestry Disability Index(ODI)score in the observation group was lower than that in the control group(P<0.05).(3)Pain degree:3 days after the operation,serumβ-endorphin(β-EP)was higher in the observation group than that in the control group,while prostaglandin E2(PGE2)and neuropeptide Y(NPY)were lower in the observation group than in the control group(P<0.05).(4)Stress response:3 days after the surgery,serum cortisol(Cor),malondialdehyde(MAD),superoxide anion(O2-)and hydroxide ion(OH-)in the observation group were all lower than those in the control group(P<0.05).Conclusion:Wiltse approach unilateral TLIF treatment of FLLDH can not only shorten the duration of surgery,reduce the intraoperative blood loss and postoperative drainage volume,and relieve pain,but can also improve the lumbar function of patients and have little influence on stress response.
作者
杨贤玉
董胜利
刘帅
李来好
高振甫
YANG Xianyu;DONG Shengli;LIU Shuai;LI laihao;GAO Zhenfu(Department of Spinal Surgery,General Hospital of Pingmei Shenma Medical Group,Pingdingshan,Henan 467000,China)
出处
《淮海医药》
CAS
2021年第2期138-140,144,共4页
Journal of Huaihai Medicine
关键词
极外侧型腰椎间盘突出症
椎旁肌间隙入路
后正中入路
椎间孔椎体间融合术
Far lateral lumbar disc herniation
Paravertebral muscle space approach
Posterior median approach
Transforaminal lumbar interbody fusion
