【摘要】：目的探討Quadrant通道下微創(chuàng)腰椎后路融合術(shù)治療單節(jié)段腰椎退行性疾病的臨床效果。方法回顧性分析2014年11月至2016年3月南京醫(yī)科大學(xué)附屬蘇州醫(yī)院收治的12例單節(jié)段腰椎退行性疾病的臨床資料,所有患者均在Quadrant通道下經(jīng)多裂肌與最長肌間隙行微創(chuàng)腰椎后路融合手術(shù)。其中腰椎后路椎體間融合10例、腰椎后外側(cè)融合2例。記錄手術(shù)時(shí)間、術(shù)中出血量、術(shù)后引流量、術(shù)后血紅蛋白水平,以及術(shù)前、末次隨訪時(shí)疼痛視覺模擬量表(VAS)評分和Oswestry功能障礙指數(shù)(ODI)。結(jié)果手術(shù)時(shí)間120~260 min,平均手術(shù)時(shí)間180 min;術(shù)中出血量50~800 mL,平均術(shù)中出血量375 mL;術(shù)后引流量8~321 mL,平均引流量128mL;術(shù)后血紅蛋白水平93~138 g/L,平均血紅蛋白水平113 g/L。所有患者無腦脊液漏、神經(jīng)根損傷、感染及術(shù)后頑固性腰背痛發(fā)生。隨訪5~21個(gè)月(平均16個(gè)月),術(shù)前、術(shù)后末次隨訪VAS評分和ODI分別為(6.4±1.0)、(2.0±0.7)分和(18±4)、(46±10)分,手術(shù)前后比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 Quadrant通道下經(jīng)多裂肌與最長肌間隙入路行腰椎后路融合手術(shù)治療單節(jié)段腰椎退行性疾病具有出血少、對后方韌帶破壞小、脊柱穩(wěn)定性好、功能恢復(fù)快等優(yōu)點(diǎn),符合微創(chuàng)理念,值得臨床推廣應(yīng)用。
[Abstract]:Objective to investigate the clinical effect of minimally invasive posterior lumbar fusion under Quadrant channel in the treatment of single segment lumbar degenerative diseases. Methods from November 2014 to March 2016, the clinical data of 12 cases of single segment lumbar degenerative diseases treated in Suzhou Hospital of Nanjing Medical University were retrospectively analyzed. All patients underwent minimally invasive posterior lumbar fusion through the intermuscular space of polyfissure and longissimus under Quadrant channel. Posterior lumbar interbody fusion was performed in 10 cases and posterolateral lumbar fusion in 2 cases. Time of operation, intraoperative blood loss, postoperative drainage, postoperative hemoglobin level, preoperative and last follow-up pain visual analogue scale (VAS) score and Oswestry dysfunction index (ODI).) were recorded. Results the operative time was 120 ~ 260 min, the average operation time was 180 min, the blood loss was 50 ~ 800 mL, the average intraoperative bleeding was 375 mL, the postoperative drainage flow was 8 ~ 321 mL, the average drainage flow was 128 mL, and the postoperative hemoglobin level was 93 ~ 138 g / L, with an average hemoglobin level of 113 g 路L ~ (-1). No cerebrospinal fluid leakage, nerve root injury, infection and intractable low back pain occurred in all patients. The VAS score and ODI of the last follow-up were (6.4 鹵1.0), (2.0 鹵0.7) and (18 鹵4), (46 鹵10), respectively. There were significant differences before and after operation (P0.05). Conclusion posterior lumbar fusion under Quadrant channel for the treatment of single segment lumbar degenerative diseases through the interspace of polyfissure and longissimus has the advantages of less bleeding, less damage to the posterior ligaments, good stability of the spine and quick recovery of function. It accords with the idea of minimally invasive and is worth popularizing and applying in clinic.
【作者單位】： 南京醫(yī)科大學(xué)附屬蘇州醫(yī)院骨科;
【分類號】：R687.3

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