本文關(guān)鍵詞： 經(jīng)皮椎弓根螺釘 椎弓根鏡 微創(chuàng)內(nèi)固定術(shù) 腰椎退行性疾病 治療結(jié)果　出處：《重慶醫(yī)學(xué)》2017年18期 　論文類型：期刊論文

【摘要】：目的比較傳統(tǒng)經(jīng)皮置釘與椎弓根鏡輔助下經(jīng)皮置釘技術(shù)治療腰椎退行性疾病(LDD)的安全性和準(zhǔn)確性。方法選擇廣州醫(yī)科大學(xué)附屬第一醫(yī)院2013年12月至2015年9月采用經(jīng)皮置釘?shù)腖DD患者30例,將其分為經(jīng)皮組和鏡下組,每組15例,比較兩組患者術(shù)中出血量、住院時間及并發(fā)癥,采用視覺模擬量表(VAS)和Oswestry功能障礙指數(shù)(ODI)進(jìn)行療效評估。術(shù)后復(fù)查X線、CT及磁共振成像(MRI),評估螺釘位置及融合率。結(jié)果經(jīng)皮組置釘84枚,鏡下組置釘70枚。兩組術(shù)中平均出血、手術(shù)平均時間、C臂透視平均次數(shù)、住院平均時間、術(shù)后下床時間及并發(fā)癥發(fā)生率比較差異無統(tǒng)計學(xué)意義(P0.05)。隨訪6個月,兩組患者VAS及ODI評分較術(shù)前明顯改善(P0.01);鏡下組VAS及ODI分別為(2.50±1.30)分及(50.00±3.50)%,經(jīng)皮組VAS及ODI分別為(3.00±1.50)分及(58.00±4.50)%,兩組比較差異有統(tǒng)計學(xué)意義(P0.05)。經(jīng)皮組、鏡下組臨床癥狀改善率為73.33%、80.00%;置釘位置經(jīng)影像學(xué)復(fù)查,顯示位置良好,病變節(jié)段融合良好,無螺釘松動。經(jīng)皮組3枚(3.57%)螺釘位置偏差,行二次手術(shù)調(diào)整。結(jié)論椎弓根鏡輔助下置釘治療LDD的準(zhǔn)確性及安全性均高于傳統(tǒng)經(jīng)皮置釘,且手術(shù)時間更短,術(shù)中出血更少。
[Abstract]:Objective to compare the safety and accuracy of traditional percutaneous nail and pedicle screw assisted percutaneous nail in the treatment of lumbar degenerative diseases. Methods the first affiliated Hospital of Guangzhou Medical University was selected from December 2013 to September 2015. There were 30 cases of LDD with percutaneous nail insertion. The patients were divided into percutaneous group (n = 15) and endoscopic group (n = 15). The amount of intraoperative bleeding, hospital stay and complications were compared between the two groups. Visual analogue scale (vas) and Oswestry dysfunction index (ODI) were used to evaluate the efficacy. After operation, X-ray CT and Mr imaging were performed to evaluate the screw position and fusion rate. Results 84 screws were placed in the percutaneous group and 70 nails were placed under the microscope. There was no significant difference in the average time of operation, the average time of hospitalization, the time of getting out of bed after operation and the incidence of complications (P 0.05). All patients were followed up for 6 months. The scores of VAS and ODI in the two groups were significantly improved compared with those before operation, the scores of VAS and ODI in the two groups were 2.50 鹵1.30) and 50.00 鹵3.50, respectively, and the scores of VAS and ODI in the percutaneous group were 3.00 鹵1.50 and 58.00 鹵4.50, respectively. The difference between the two groups was statistically significant (P 0.05). The improvement rate of clinical symptoms was 73.33 and 80.00.The position of the screw was well located, the lesion segment was fused well, and no screw loosened. The position deviation of the screw in the percutaneous group was 3.57). Conclusion the accuracy and safety of pedicle assisted screw placement in the treatment of LDD is higher than that of traditional percutaneous nail, and the operation time is shorter and the bleeding is less.
【作者單位】： 廣州醫(yī)科大學(xué)附屬第五醫(yī)院骨科;廣州醫(yī)科大學(xué)附屬第一醫(yī)院脊柱外科/廣州骨科研究所;
【基金】：廣東省科技計劃項目(2014A020212369)
【分類號】：R687.3
，

本文編號：1518277