[1]竺义亮 王小阵 陈龙 朱凌 鲁齐林△.后路有限精准减压融合术治疗双节段混合型腰椎管狭窄症71例[J].中国中医骨伤科杂志,2020,28(12):73-76.
点击复制

后路有限精准减压融合术治疗双节段混合型腰椎管狭窄症71例()
分享到:

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

卷:
第28卷
期数:
2020年12期
页码:
73-76
栏目:
临床报道
出版日期:
2020-12-15

文章信息/Info

文章编号:
1005-0205(2020)12-0073-04
作者:
竺义亮1 王小阵1 陈龙1 朱凌1 鲁齐林1△
1湖北六七二中西医结合骨科医院脊柱外科(武汉,430079)通信作者 E-mail:gkluql @163.com
关键词:
有限精准减压融合术 混合型腰椎管狭窄症 改良后路手术
分类号:
R681.5
文献标志码:
B
摘要:
目的:探讨后路有限精准减压融合术治疗双节段混合型腰椎管狭窄症的临床疗效及优势。方法:回顾性分析2016年1月至2020年1月用有限精准减压融合术(改良T-PLIF)治疗的双节段混合型腰椎管狭窄症患者71例,记录患者手术时间、术中出血量、下床活动时间,评估术前及术后12个月腰腿痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)及术后并发症发生率。结果:有2例因为椎板骨质咬除过多,下关节突断裂导致未精准实行改良T-PLIF而剔除,另有5例失访,共64例完成手术及随访。手术时间(137.46±10.63)min,术中出血量(246.13±20.42)mL,下床时间(3.28±0.90)d,无螺钉拔钉现象或Cage下沉,也无神经血管及脏器损伤。术后2例患者出现手术切口延迟愈合,经加强换药后愈合良好。结论:对于双节段混合型腰椎管狭窄症患者,采用精准减压融合术能够在精准减压神经根的同时,最大限度地保留脊柱结构完整性,降低并发症发生率,具有较好的临床疗效。该技术易于掌握,值得临床推广应用。

参考文献/References:

[1] COSTANDI S, CHOPKO B, MEKHAIL M,et al.Lumbar spinal stenosis:therapeutic options review[J].Journal of World Institute of Pain,2015,15(1):68-81.
[2] TACCONI L,BOBICCHIO P.Preliminary results of a novel pure endoscopic procedure in the treatment of degenerative lumbar spinal disorders:double endoscopic technique[J].J Neurosurg Sci,2018,21(1):51-57.
[3] YOO J S,HRYNEWYCZ N M,BRUNDAGE T S,et al.The use of patient-reported outcome measurement information system physical function to predict outcomes based on body mass index following minimally invasive transforaminal lumbar interbody fusion[J].Spine(Phila Pa 1976),2019,44(23):E1388-E1395.
[4] KREINER D S, SHAFFER W O, BAISDEN J L,et al.An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis(update)[J].Spine J,2013,13(7):734-743.
[5] CZABANKA M,THOMé C,RINGEL F,et al.Operative treatment of degenerative diseases of the lumbar spine[J].Nervenarzt,2018,89(6):639-647.
[6] HAMAWANDI S A, SULAIMAN I I, AL-HUMAIRI A K.Micro decompression versus open laminectomy and posterior stabilization for multilevel lumbar spine stenosis:a randomized controlled trial[J].Pain Res Manag,2019(4):1-6.
[7] LI Y Z,ZHANG H W,ZHANG X G,et al.Efficacy and safety of percutaneous endoscopic decompression via transforaminal and interlaminar approaches for lumbar spine stenosis:protocol for a systematic review and meta-analysis[J].Medicine(Baltimore),2020,99(1):e18555.
[8] PARK C H, LEE S H.Endoscope-assisted minimally invasive interlaminar lumbar decompression for spinal stenosis[J].Pain Physician,2019,22(6):573-578.
[9] DOBRAN M,NASI D,GLADI M,et al.Clinical and psychological outcome after surgery for lumbar spinal stenosis:a prospective observational study with analysis of prognostic factors[J].Neurol Neurochir Pol,2018,52(1):70-74.
[10] 孔超,鲁世保,孙祥耀,等.高龄腰椎管狭窄症患者手术治疗的安全性及有效性[J].中国脊柱脊髓杂志,2018,28(11):1004-1010.
[11] ISHIHARA Y,MORISHITA M,MIYAKI J,et al.Comparison of transforaminal lumbar interbody fusion using the boomerang-shaped cage with traditional posterior lumbar interbody fusion for lumbar spondylolisthesis[J].Spine Surg Relat Res,2018,3(1):71-78.
[12] 田杰,茹江英.腰椎管扩大减压术中保留棘突韧带复合体的优势与问题[J].中国组织工程研究,2019,23(8):1228-1234.
[13] KIM J T,SHIN M H,LEE H J,et al.Restoration of lumbopelvic sagittal alignment and its maintenance following transforaminal lumbar interbody fusion(TLIF):comparison between straight type versus curvilinear type cage[J].Eur Spine J,2015,24(11):2588-2596.
[14] FU Z Y,SHI J G,JIA L S.Limited laminectomy versus standard laminectomy with posterior instrumentation for lumbar spinal canal stenosis[J].Orthop J Chin,2014,22(15):1347-1352.
[15] PICH J.Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis[J].Orthop Nurs,2018,37(5):318-319.
[16] 杨洪佳,李荣文,周长友,等.精准减压与全椎板切除减压手术治疗腰椎管狭窄症的疗效对比[J].颈腰痛杂志,2018,39(6):761-764.

备注/Memo

备注/Memo:
基金项目:武汉市卫生健康科研基金资助项目(WX18A04)湖北省卫生健康科研基金资助项目(WJ2019H429)
更新日期/Last Update: 2020-12-15