[1]邵卫东 徐用亿.改良骨膜下入路经椎间孔腰椎椎间融合术治疗腰椎间盘突出症[J].中国中医骨伤科杂志,2021,29(01):62-64.
　SHAO Weidong XU Yongyi.Treatment of Lumbar Disc Herniation with Modified SubperiostealApproach through Intervertebral Foramen and Lumbar Interbody Fusion[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(01):62-64.
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改良骨膜下入路经椎间孔腰椎椎间融合术治疗腰椎间盘突出症()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年01期
页码:
62-64
栏目:
临床报道
出版日期:
2021-01-15

文章信息/Info

Title:
Treatment of Lumbar Disc Herniation with Modified SubperiostealApproach through Intervertebral Foramen and Lumbar Interbody Fusion
文章编号:
1005-0205(2021)01-0062-03
作者:
邵卫东1 徐用亿2
Author(s):
SHAO Weidong1 XU Yongyi2
1Department of Orthopaedics,Branch Hospital of Huai’an First People’s Hospital,Huai’an 223002,Jiangsu China; 2Department of Orthopaedics,Huai’an First Hospital Affiliated to Nanjing Medical University,Huai’an 223002,Jiangsu China.
关键词:
改良骨膜下入路;  经椎间孔腰椎椎间融合术;  腰椎间盘突出症;  椎旁肌
Keywords:
modified subperiosteal approach;  transforaminal lumbar interbody fusion;  lumbar disc herniation;  paravertebral muscles
分类号:
R681.5
文献标志码:
B
摘要:
目的:探讨改良骨膜下入路经椎间孔腰椎椎间融合术(TLIF)治疗腰椎间盘突出症(LDH)的临床疗效。方法:对2016年8月至2018年8月本院66例LDH患者,采用改良骨膜下入路TLIF治疗,记录围术期相关指标及并发症发生情况,术前、术后1 d、3个月、1年评价疼痛视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI),比较术前及术后1年椎旁肌脂肪浸润程度及肌面积。结果:所有患者均完成手术,手术时间(129.89±11.83)min,术中出血量(165.49±19.36)mL,引流量(138.39±19.24)mL,住院(6.04±1.20)d。术后发生1例慢性腰背痛,1例切口感染。术后1 d,术后3个月及术后1年VAS评分和ODI评分均显著降低,差异有统计学意义(P<0.05)。术后1年椎旁肌脂肪浸润程度及肌面积与术前差异无统计学意义(P>0.05)。结论:改良骨膜下入路TLIF治疗LDH能获得良好的临床疗效,手术创伤小,并发症发生率低,能降低椎旁肌肉萎缩。
Abstract:
To explore the clinical effect of modified subperiosteal approach through intervertebral foramen and lumbar interbody fusion(TLIF)in the treatment of lumbar disc herniation(LDH).Methods:66 patients with LDH in our hospital from August 2016 to August 2018 were selected as the study subjects,and all patients were treated by modified subperiosteal approach TLIF.The related perioperative indicators and the occurrence of complications were recorded.The preoperative and postoperative 1 d,3 months,1 year evaluation pain visual analogue scale(VAS)score and Oswestry dysfunction index(ODI)were compared between the two groups.The fat infiltration degree and muscle area of paraspinal muscles were compared before and 1 year after operation.Results:All patients’ operation were completed,the operation time was(129.89±11.83)min,intraoperative blood loss(165.49±19.36)mL,drainage volume(138.39±19.24)mL,hospitalization(6.04±1.20)d.1 case showed chronic low back pain,and 1 case incision infection occurred after operation.The VAS score and ODI at 1 d,3 months and 1 year after operation were decreased with statistically significant difference(P<0.05).There was no statistically significant difference in the degree of fat infiltration and muscle area of paravertebral muscle 1 year after operation(P>0.05).Conclusion:Modified subperiosteal approach TLIF can obtain good clinical efficacy in the treatment of LDH,with less surgical trauma and low complication rate,and can reduce paravertebral muscle atrophy.

参考文献/References:

[1] 贾军,刘新宇,原所茂,等.微创与开放经椎间孔腰椎间融合术后中期邻近节段影像学退变的比较[J].中华骨科杂志,2019,39(12):766-773.
[2] 李佳奇,王林峰,高显达,等.MIS-TLIF治疗腰椎退变性疾病的研究进展[J].中国矫形外科杂志,2018,26(7):631-634.
[3] 孟凡剑,成茂华,周晓中,等.改良骨膜下与肌间隙入路胸腰椎固定术比较[J].中国矫形外科杂志,2020,28(2):118-122.
[4] COZZOLINO M,COCCIA M, LAZZERI G,et al.Variables associated with endometriosis-related pain:a pilot study using a visual analogue scale[J].Revista Brasileira de Ginecologia e Obstetrícia,2019,41(3):170-175.
[5] 程继伟,王振林,刘伟,等.Oswestry功能障碍指数的改良及信度和效度检验[J].中国脊柱脊髓杂志,2017,27(3):235-241.
[6] 戎飞龙,尹若峰,冯蒙蒙,等.退变性腰椎滑脱症和腰椎管狭窄症与椎体周围肌容量的相关性:CT和MRI影像资料分析[J].中国组织工程研究,2019,23(24):74-79.
[7] 赵银霞,李绍林,陈佳玲,等.腰椎旁肌脂肪浸润与椎间盘退变及年龄的相关性研究[J].临床放射学杂志,2018,37(9):1538-1541.
[8] 许沛荣,肖俊,朱锋,等.经椎旁肌间隙入路椎弓根钉内固定治疗中青年胸腰椎骨折疗效观察[J].中国骨与关节损伤杂志,2018,33(11):52-53.
[9] 沈筠恬,喻妙梅,仇嘉颖,等.快肌与慢肌失神经支配后的形态学变化[J].解剖学杂志,2019,42(2):63-68.
[10] 李锋,徐勇,熊伟,等.后路经肌间隙保留颈后伸肌群入路的颈椎椎板成形术的技术要点及临床应用[J].骨科,2019,10(5):412-417.
[11] 张欣,何钊,李涛.骶1节段多裂肌劈开入路行MIS-TILF治疗腰椎滑脱症的临床疗效观察[J].解放军预防医学杂志,2018,36(12):49-51.
[12] 张海滨,刘先银,黎松波,等.微创可扩张通道下TILF术与开放PILF术治疗腰椎双侧峡部裂滑脱效果对比[J].山东医药,2018,58(21):88-90.
[13] 李方财,陈其昕,陈维善.改良侧方入路腰椎椎体间融合术及其临床应用[J].中华骨科杂志,2018,38(4):212-219.

备注/Memo

备注/Memo:
基金项目:江苏省自然科学基金(BK20170369)
1江苏淮安市第一人民医院分院骨科(江苏 淮安,223002)
2南京医科大学附属淮安第一医院骨科
更新日期/Last Update: 2021-01-15