| 自制微创拉钩辅助改良双侧Wiltse入路经椎间孔椎体间融合术在腰椎退行性病变治疗中的应用 |
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投稿时间：2020-03-09
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| 作者 | Author | 单位 | Address | E-Mail |
| 谷艳超 |
GU Yan-chao |
湖北六七二中西医结合骨科医院, 湖北 武汉 430000 |
Hubei 672 Integrated Chinese and Western Medicine Orthopaedics Hospital, Wuhan 430000, Hubei, China |
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| 朱凌 |
ZHU Ling |
湖北六七二中西医结合骨科医院, 湖北 武汉 430000 |
Hubei 672 Integrated Chinese and Western Medicine Orthopaedics Hospital, Wuhan 430000, Hubei, China |
770552435@qq.com |
| 胡胜利 |
HU Sheng-li |
湖北六七二中西医结合骨科医院, 湖北 武汉 430000 |
Hubei 672 Integrated Chinese and Western Medicine Orthopaedics Hospital, Wuhan 430000, Hubei, China |
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| 谢维 |
XIE Wei |
湖北六七二中西医结合骨科医院, 湖北 武汉 430000 |
Hubei 672 Integrated Chinese and Western Medicine Orthopaedics Hospital, Wuhan 430000, Hubei, China |
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| 吉璐宏 |
JI Lu-hong |
湖北六七二中西医结合骨科医院, 湖北 武汉 430000 |
Hubei 672 Integrated Chinese and Western Medicine Orthopaedics Hospital, Wuhan 430000, Hubei, China |
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| 严浩 |
YAN Hao |
湖北六七二中西医结合骨科医院, 湖北 武汉 430000 |
Hubei 672 Integrated Chinese and Western Medicine Orthopaedics Hospital, Wuhan 430000, Hubei, China |
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| 陈旺 |
CHEN Wang |
湖北六七二中西医结合骨科医院, 湖北 武汉 430000 |
Hubei 672 Integrated Chinese and Western Medicine Orthopaedics Hospital, Wuhan 430000, Hubei, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第4期，第297-303页 |
| DOI：10.12200/j.issn.1003-0034.2021.04.002 |
| 基金项目: |
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中文摘要:
目的： 探讨自制微创拉钩辅助改良双侧Wiltse入路经椎间孔椎体间融合术（transforaminal lumbar interbody fusion，TLIF）在治疗腰椎退行性病变中的优势。
方法： 回顾性分析2016年10月至2017年10月行腰椎融合手术的140例患者的临床资料，其中72例患者采用自制微创拉钩辅助改良双侧Wiltse入路TLIF治疗（A组），男37例，女35例，年龄（48±16）岁；68例采用传统后正中入路TLIF治疗（B组），男38例，女30例，年龄（45±15）岁。记录两组患者的手术切口大小、手术时间、术中出血量、术后引流量、术后伤口愈合情况及末次随访椎间融合率，并采用疼痛视觉模拟评分（visual analogue scale，VAS）和Oswestry功能障碍指数（Oswestry Disability Index，ODI）对两组患者的临床疗效进行评定。
结果： 所有患者获得随访，时间3~13（8±5）个月。A组患者术后伤口愈合良好，B组术后发生伤口坏死1例，经清创缝合后痊愈。两种手术方式在手术时间、术后融合率方面差异无统计学意义（P>0.05）；A组在手术切口大小、术中出血量、术后引流量方面有明显优势（P<0.05），且术后的腰腿痛VAS评分及ODI均优于B组（P<0.05）。
结论： 自制微创拉钩辅助改良双侧Wiltse入路TLIF在治疗腰椎退行性病变中具有微创、术中出血量少、术后引流少、并发症少、融合稳定等特点。 |
| 【关键词】椎间盘退行性变 手术操作 脊柱融合术 |
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| Clinical application of self-made minimally invasive hood-assisted transforaminal lumbar interbody fusion via modified bilateral Wiltse approach in the treatment of lumbar degenerative diseases |
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ABSTRACT
Objective: To explore the advantages of self-made minimally invasive hook-assisted transforaminal lumbar interbody fusion (TLIF) via modified bilateral Wiltse approach in the treatment of lumbar degenerative diseases.
Methods: The clinical data of 140 patients underwent lumbar spine fusion surgery from October 2016 to October 2017 were retrospectively analyzed. Among them,72 cases were treated by self-made minimally invasive hook-assisted TLIF via modified bilateral Wiltse approach (group A),there were 37 males and 35 females,aged (48±16) years old;68 cases were treated by TLIF via traditional posterior median approach (group B),there were 38 males and 30 females,aged (45±15) years old. The surgical incision size,operation time,intraoperative blood loss volume,postoperative drainage volume,postoperative wound healing,and intervertebral fusion rate at the final follow-up were recorded between two groups. Visual analogue scale(VAS) and Oswestry Disability Index(ODI) were used to assess the clinical efficacy.
Results: All the patients were followed up for 3 to 13(8±5) months. The wound in group A healed well after operation,and 1 case in group B occurred wound necrosis after operation,and healed after debridement and suture. There were no significant differences in operation time and postoperative fusion rate between two surgical methods(P>0.05). Group A had obvious advantages in surgical incision size,intraoperative blood loss volume and postoperative drainage volume(P<0.05),and the postoperative VAS score of low back pain and ODI were better than group B(P<0.05).
Conclusion: The self-made minimally invasive hook-assisted TLIF via modified bilateral Wiltse approach has the characteristics of minimally invasive,less intraoperative blood loss,less postoperative drainage,fewer complications,and more stable fusion in the treatment of lumbar degenerative desease. |
| KEY WORDS Intervertebral disc degeneration Operative procedures Spinal fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 谷艳超,朱凌,胡胜利,谢维,吉璐宏,严浩,陈旺.自制微创拉钩辅助改良双侧Wiltse入路经椎间孔椎体间融合术在腰椎退行性病变治疗中的应用[J].中国骨伤,2021,34(4):297~303 |
| 英文格式: | GU Yan-chao,ZHU Ling,HU Sheng-li,XIE Wei,JI Lu-hong,YAN Hao,CHEN Wang.Clinical application of self-made minimally invasive hood-assisted transforaminal lumbar interbody fusion via modified bilateral Wiltse approach in the treatment of lumbar degenerative diseases[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(4):297~303 |
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