[1]吴伟,罗先进△,余淼.微创经椎间孔腰椎椎体间融合术中预弯钛棒对临床疗效的影响[J].中国中医骨伤科杂志,2025,33(06):56-62.[doi:10.20085/j.cnki.issn1005-0205.250610]
　WU Wei,LUO Xianjin,YU Miao.The Effect of Pre-Bent Titanium Rod Contour on the Clinical Efficacy in Minimally Invasive Surgery-Transforaminal Lumbar Interbody Fusion[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(06):56-62.[doi:10.20085/j.cnki.issn1005-0205.250610]
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微创经椎间孔腰椎椎体间融合术中预弯钛棒对临床疗效的影响()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年06期
页码:
56-62
栏目:
临床论著
出版日期:
2025-06-15

文章信息/Info

Title:
The Effect of Pre-Bent Titanium Rod Contour on the Clinical Efficacy in Minimally Invasive Surgery-Transforaminal Lumbar Interbody Fusion
文章编号:
1005-0205(2025)06-0056-07
作者:
吴伟1; 罗先进1△; 余淼2
1重庆两江新区人民医院(重庆,401121) 2陆军军医大学第二附属医院
Author(s):
WU Wei1; LUO Xianjin1△; YU Miao2
1Chongqing Liangjiang New District People's Hospital,Chongqing 401121,China; 2The Second Affiliated Hospital of Army Medical University,Chongqing 400030,China.
关键词:
预弯钛棒;  微创经椎间孔腰椎椎体间融合术;  脊柱矢状位序列
Keywords:
titanium rod contoured;  minimally invasive transforaminal lumbar interbody fusion;  spinal sagittal alignment
分类号:
R687.3
DOI:
10.20085/j.cnki.issn1005-0205.250610
文献标志码:
A
摘要:
目的:评价预弯钛棒在单节段微创经椎间孔腰椎椎体间融合术(MIS-TLIF)中脊柱矢状位序列及患者自评临床疗效的影响。方法:回顾性分析2020年1月至2022年4月连续完整随访2年以上的单节段腰椎病变患者,均开展微创经椎间孔腰椎椎体间融合手术,根据术中预弯操作分为预弯钛棒组(51例)和非预弯钛棒组(43例)。术后2年测量影像学参数,包括矢状位偏移(SVA)、胸椎后凸角(TK)、胸腰联合角(TLJ)、腰椎前凸角(LL)、骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)、椎间高度(DH)、融合节段角(FSA)。临床疗效评估包括围术期指标(手术时间、术中出血量)及问卷评分——疼痛视觉模拟量表(VAS)评分和Oswestry功能障碍指数(ODI)评分。结果:所有患者获得2年以上随访,两组患者术后2年随访时腰椎前凸角、骶骨倾斜角、骨盆倾斜角较术前显著改善,差异有统计学意义(P<0.05),矢状位偏移、胸椎后凸角、胸腰联合角与术前对比差异无统计学差意义(P>0.05)。2年随访时两组患者局部矢状位参数(椎间高度、融合节段角)较术前显著增大,差异有统计学意义(P<0.05)。患者自评临床疗效VAS评分和ODI评分较术前明显改善,差异有统计学意义(P<0.05)。两组患者手术时间、术中出血量、脊柱-骨盆矢状位参数、椎间高度、VAS评分、ODI评分组间比较差异无统计学意义(P>0.05),预弯钛棒组融合节段角改善程度较非预弯钛棒组明显(4.62±3.47比2.63±3.12,P=0.005)。结论:微创经椎间孔腰椎椎体间融合术可以重建腰椎前凸角,减少骨盆后倾位代偿。即使是在单节段微创经椎间孔腰椎椎体间融合手术中,预弯钛棒是必要的,可以更好地重建融合节段角。
Abstract:
Objective:To analyse the effect of rod contouring on spinal-pelvic sagittal parameters and 2-year follow-up clinical outcomes in single-segment minimally invasive surgery-transforaminal lumbar interbody fusion(MIS-TLIF).Methods:A retrospective analysis was performed on 94 patients with single-segment lumbar degenerative disease who underwent MIS-TLIF surgery from January 2020 to April 2022.The patients were divided into the contouring rod group(n=51)and the non-contouring rod group(n=43).Radiological measurements of spinal-pelvic and focus sagittal parameters,including:sagittal vertical axis(SVA),thoracic kyphosis(TK),thoracolumbar junction(TLJ),lumbar lordosis(LL),pelvic incidence(PI),pelvic tilt(PT),and sacral slope(SS),disc height(DH)and fused segmental angle(FSA).Operation time,intraoperative blood loss,visual analogue scale(VAS)and Oswestry disability index(ODI)scores were used to evaluate clinical outcomes.Results:According to spinal-pelvic parameters,LL,SS and PT significantly improved(P<0.05),while SVA,TK and TLJ were not significantly changed at the 2-year follow-up in both groups(P>0.05).The DH and FSA were significantly increased in both groups(P<0.05).According to clinical outcomes,VAS and ODI scores of two groups were significantly ameliorated than preoperative data(P<0.05).There were no significant differences between groups in operation time,intraoperative blood loss,global and sagittal parameters,VAS and ODI scores(P>0.05).The recovery degree of fused segmental angle in the contouring rod group was significantly increased compared with that in the non-contouring rod group(4.62±3.47 vs 2.63±3.12,P=0.005).Conclusion:MIS-TLIF can effectively reconstruct lumbar lordosis and reduce the compensation of backward pelvic tilt.Even in single segment MIS-TLIF,pre-bending titanium rods are necessary to better reconstruct the FSA.

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备注/Memo

备注/Memo:
△通信作者 E-mail:2330065540@qq.com
更新日期/Last Update: 2025-06-15