毛克亚,王 岩,肖嵩华,张永刚,刘保卫,张西峰,崔 庚,张雪松,程自申,李 鹏.微创手术治疗单节段腰椎管狭窄症的疗效评价[J].中国脊柱脊髓杂志,2011,(2):113-117. |
微创手术治疗单节段腰椎管狭窄症的疗效评价 |
中文关键词: 腰椎管狭窄症 微创手术 开放手术 治疗效果 |
中文摘要: |
【摘要】 目的:对比微创手术与传统开放手术治疗单节段腰椎管狭窄症的临床效果,评价微创手术治疗腰椎管狭窄症的安全性和有效性。方法:2008年1月~2009年1月收治43例单节段腰椎管狭窄症患者,其中28例采用传统开放减压、后路椎体间融合手术(posterior interbody fusion,PLIF)治疗(A组),15例采用微创减压、经椎间孔融合手术(transforaminal lumbar interbody fusion,TLIF)治疗(B组),比较两组患者的手术时间、术中C型臂X线机照射时间、术中出血量、术后引流量、术后下地时间和术后平均住院时间,并分别采用Oswestry disability index(ODI)、visual analogue scores(VAS)和X线评价治疗效果。结果:所有患者均获得随访,两组术前一般资料、VAS和ODI评分无显著性差异。B组手术时间和术中透视时间多于A组(P<0.01),而术中出血量和术后引流量B组明显低于A组(P<0.01),术后下地活动时间和术后平均住院日B组明显短于A组(P<0.01)。术后5d时VAS评分B组优于A组(P<0.05),而其他时间相比两组VAS评分与ODI评分相比均无显著性差异(P>0.05),术后X线评价融合率两组亦无显著性差异(P>0.05)。结论:与传统开放手术相比,微创手术治疗单节段腰椎管狭窄症,同样可以获得安全、有效的治疗结果,并且在手术出血量、术后引流量、术后下地活动时间和术后住院时间方面优于传统开放手术。 |
Outcomes of minimally invasive treatment for single level lumbar stenosis |
英文关键词:Lumbar stenosis Minimally invasive Open |
英文摘要: |
【Abstract】 Objective:To compare the clinical outcomes of minimally invasive surgery(MIS) and open surgery for single-level lumbar stenosis and to evaluate the safety and reliability of MIS for single-level lumbar stenosis.Method:From Jan 2008 to Jan 2009,15 patients with single level lumbar stenosis underwent single-level MIS decompression and transforaminal lumbar interbody fusion(TLIF),while 45 cases with the same problems underwent traditional open decompression and posterior lumbar interbody fusion(PLIF).The operative time,X-ray exposure time,pereoperative blood loss,postoperative ambulation,and bed time were compared between two groups.Futhermore,clinical outcomes in terms of Oswestry Disability Index(ODI),back and leg pain Visual Analogue scores(VAS),and X-ray examination were performed before surgery,after surgery and during follow-up.Result:There was no difference with respect to preoperative demographic data,VAS and ODI scores between two groups.MIS group had longer operative time and X-ray exposure time than open group(P<0.01),but less pereoperative blood loss than open group(P<0.01).MIS group had shorter postoperative bed time than open group(P<0.01).The VAS score of back pain at 5th day postoperative in MIS group was higher than open group(P<0.05).There was no difference between two groups with respect to VAS and ODI scores at other timepoints.No difference for lumbar fusion rate was noted between two groups.Conclusion:MIS and open groups can achieve similar safety and reliability,but as for the pereoperative blood loss,postoperative bed time,MIS group is superior than open group. |
投稿时间:2010-09-07 修订日期:2010-12-31 |
DOI:10.3969/j.issn.1004-406X.2011.2.113.4 |
基金项目:基金项目:国家自然科学基金(编号:39670731),国家863计划(编号:2009AA02Z405) |
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