本文選題：小切口 + 腰椎��； 參考：《浙江大學(xué)》2015年碩士論文

【摘要】：目的：對(duì)比研究Wiltse肌間隙入路與傳統(tǒng)入路術(shù)式,在小切口經(jīng)椎間孔腰椎椎體間融合(TLIF)術(shù)中,對(duì)各節(jié)段小關(guān)節(jié)突關(guān)節(jié)累及率的差別。 研究設(shè)計(jì)：回顧性研究。 研究對(duì)象：自2012年6月至2014年12月,應(yīng)用小切口TLIF術(shù)治療患者。 觀察項(xiàng)目：所有患者常規(guī)進(jìn)行術(shù)后CT復(fù)查評(píng)估手術(shù)節(jié)段的小關(guān)節(jié)突關(guān)節(jié)累及率。 方法：應(yīng)用小切口TLIF術(shù)治療一組連續(xù)的單側(cè)下肢癥狀腰椎退行性病變患者共101例。減壓側(cè)統(tǒng)一通過(guò)傳統(tǒng)入路,非減壓側(cè)經(jīng)Wiltse肌間隙入路。術(shù)后常規(guī)CT檢查評(píng)估手術(shù)節(jié)段的小關(guān)節(jié)突關(guān)節(jié)累及率。 結(jié)果：共有101例連續(xù)的患者(452枚椎弓根螺釘)符合研究標(biāo)準(zhǔn)被納入研究對(duì)象中,包括79例單節(jié)段融合、20例雙節(jié)段融合和2例三節(jié)段融合。經(jīng)Wiltse肌間隙入路和傳統(tǒng)入路的小關(guān)節(jié)突關(guān)節(jié)累及率分別為26.55%和35.40%。L3、L4、L5和S1節(jié)段的小關(guān)節(jié)突關(guān)節(jié)累及率分別為16.67%、20.25%、34.90%和56.45%。 結(jié)論：與傳統(tǒng)入路相比,經(jīng)Wiltse肌間隙入路能夠提高置釘?shù)木珳?zhǔn)度,顯著降低小關(guān)節(jié)突關(guān)節(jié)累及率。同樣在L5,S1節(jié)段術(shù)者也需要更加小心來(lái)避免累及到小關(guān)節(jié)突關(guān)節(jié)。
[Abstract]:Objective: to study the difference of the involvement rate of the facet joints in the small incision transforaminal lumbar interbody fusion with the traditional approach and the Wiltse intermuscular approach. Research Design: retrospective study. Participants: from June 2012 to December 2014, patients were treated with small incision TLIF. Observation items: all patients underwent routine CT reexamination to evaluate the involvement rate of facet joints. Methods: a group of 101 patients with lumbar degenerative diseases with unilateral lower extremity symptoms were treated with small incision TLIF. The decompression side was United through the traditional approach and the non-decompression side through the Wiltse approach. Postoperative routine CT scan was used to evaluate the involvement rate of facet joints. Results: a total of 101 consecutive patients with 452 pedicle screws were included in the study, including 79 cases with single segment fusion, 20 cases with double segment fusion and 2 cases with three segment fusion. The involvement rates of facet joints via Wiltse approach and traditional approach were 26.55% and 35.40%, respectively. The involvement rates of facet joints in segment L3, L4, L5 and S1 were 16.67%, 20.25%, 34.90% and 56.45%, respectively. Conclusion: compared with the traditional approach, the Wiltse approach can improve the accuracy of nail placement and significantly reduce the incidence of facet process joint involvement. Also in L _ 5 / S _ 1 segment, greater care is needed to avoid involvement of facet joints.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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本文編號(hào)：1956422