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时间:2020-04-21
《单侧椎弓根固定经椎间孔椎体间融合术治疗下腰椎退行性疾病-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、临床骨科杂志JournalofClinicalOrthopaedics2014Aug;17(4)·377·doi:10.3969/j.issn.1008-0287.2014.04.006·临床论著·单侧椎弓根固定经椎问孔椎体问融合术治疗下腰椎退行性疾病贾其余,俞宇,王林,郭万根,胡联英,程晓东摘要:目的评价单侧椎弓根固定经椎问孔腰椎椎体间融合术(TLIF)治疗下腰椎退行性疾病的疗效。方法采用单侧TLIF术治疗41例下腰椎退行性疾病患者,均为单节段手术。观察手术时间、术中出血量及并发症情况。采用腰痛和腿痛视觉模拟评分(VAS)与Oswestry功能障碍指数(
2、ODI)评价临床效果,并通过影像学检查对椎体间融合情况进行评价。结果41例均获随访,时间24~59(38±6)个月。手术时间80~180(125±10)min,术中出血量100~550(310±30)ml。手术切口均一期愈合。腰痛VAS分值由术前的(6.5±2.1)分下降至末次随访时的(2.3±0.9)分(P<0.01),腿痛VAS分值由术前的(7.6±2.3)分下降至末次随访时的(1.2±0.8)分(P<0.01),ODI由术前的54.2±10.9下降至末次随访时的13.8±2.1(P<0.O1)。末次随访融合率为95%,未发现继发性脊柱侧弯、螺钉松动、
3、断裂及Cage移位等情况。结论单侧TLIF术可有选择地治疗下腰椎退行性疾病,其疗效确切,并具有创伤小、手术时间短、出血少、并发症少等优点。关键词:腰椎退行性疾病;经椎间孔椎体间融合术;脊柱融合术中图分类号:R681.5;R687.3文献标识码:A文章编号:1008—0287(2014)04—0377—04Unilateralinstrumentedtransforaminallumbarinterbodyfusioninlowlumbardegenerativediseases.,—yu,YUYu,WANGLin,GUO耽-gen,HULian—ying,
4、CHENXiao一(DeptofOrthopaedics,theSecondPeoplesHospitalofHefeiCity,Hefei,Anhui230011,China)Abstract:0bjectiveToinvestigatetheeffectofunilateralinstrumentedtransforaminallumbarinterbodyfusion(TLIF)inthetreatmentoflowlumbardegenerativediseases.Methods41patientswithlowlumbardegenerativ
5、ediseasesinsinglesegmentweretreatedwithunilateralpediclescrewfixationTLIF.Operativetime.intraoperativebloodlossandcomplicationswereobserved.Thevisualanaloguescale(VAS)andtheOswestrydisabilityindex(ODI)wereusedtoevaluateclinicalefect,andradiographicparameterswereusedtoevaluatethefu
6、sionrates.Re-suitsAllcaseswerefollowedupfor24~59(38±6)months.Theoperativetimewas80—180(125±10)min,theintraoperativebloodlosswas100~550(310±30)m1.Allincisionshealedbyfirstintention.ThelumbarpainVASscoresdroppedfrom6.5±2.1preoperativelyto2.3±0.9atfinalfollowed—up(P<0.01),thelimbpain
7、VASscoresdroppedfrom7.6±2.3preoperativelyto1.2±0.8atfinalfollowed-up(P<0.01),theODIdroppedfrom54.2±10.9preoperativelyto13.8±2.1atfinalfollowed—up(P<0.01).Thespinefusionratewas95%atfinalfollowed—up.Noloosening,breakageofinstrumentationanddisplacementofcagewereobservedduringfollowed
8、-up.ConclusionsUnilateralinstrume
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