一次性13mm固定通道下MIS-TLIF治疗腰椎间盘突出症的对比研究OA
A comparative study of MIS-TLIF in the treatment of lumbar disc herniation under a one-time 13 mm fixed channel
目的 比较一次性13 mm固定通道与Quadrant扩张通道下微创经椎间孔入路腰椎椎间融合(minimally invasive transforaminal lumbar interbody fusion,MIS-TLIF)治疗腰椎间盘突出症手术效果.方法 回顾性研究2022年7月至2023年7月在中国人民解放军联勤保障部队第九〇八医院住院的腰椎间盘突出症37例患者,采用两种方式进行MIS-TLIF手术治疗,13 mm通道组20例,Quadrant通道组17例.统计两组患者的手术时间、术中出血量、切口长度、住院时间,以及腰腿痛VAS评分、JOA及ODI评分等随访指标进行对比研究.结果 所有患者均获得了完整随访,随访时间为12～16个月,平均(13.81±1.45)个月.在术中出血量、切口长度、手术时间等方面13 mm通道组要优于Quadrant通道组(P<0.05),但在住院时间方面两组之间比较差异无统计学意义(P>0.05).两组患者术后3 d、1个月、3个月、12个月的腰腿痛VAS评分、JOA及ODI评分均较术前明显下降(P<0.05),但两组之间比较差异无统计学意义(P>0.05).结论 一次性13 mm固定通道与Quadrant扩张通道对腰椎间盘突出症的疗效相当,均取得了良好的临床疗效.同时一次性13 mm固定通道具有可透视、创伤小、出血少、术中肌肉组织阻挡较好、术后疼痛轻等优点,相较于传统扩张通道更值得推广.
Objective To compare the surgical effects of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)in the treatment of lumbar intervertebral disc protrusion using the one-time 13 mm fixed channel and the Quadrant dilation channel.Methods A retrospective study was conducted on 37 patients with lumbar intervertebral disc protrusion who were hospitalized in the 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force from July 2022 to July 2023.MIS-TLIF surgery was performed in two ways,with 20 cases in the 13 mm fixed channel group,and 17 cases in the Quadrant dilated channel group.The operation time,blood loss,incision length,hospital stay,as well as follow-up indicators such as VAS score for low back and leg pain,JOA and ODI score of the two groups of patients were statistically analyzed for a comparative study.Results All patients were followed up completely.The follow-up period ranged from 12 to 16 months,with an average of(13.81±1.45)months.In terms of intraoperative blood loss,incision length,and operation time,the 13 mm fixed channel group was superior to the Quadrant dilated channel group(P<0.05),but there was no statistically significant difference in hospital stay between the 13 mm fixed channel group and the Quadrant dilated channel group(P>0.05).The VAS scores of low back and leg pain,JOA and ODI scores of the two groups of patients on the 3rd day,1 month,3 months and 12 months after the operation were significantly lower than those before the operation(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).Conclusion The one-time 13 mm fixed channel and the Quadrant dilation channel have comparable therapeutic effects on lumbar intervertebral disc protrusion,and both have achieved good clinical efficacy.At the same time,the one-time 13 mm fixed channel has the advantages of fluoroscopy,less trauma,less bleeding,better intraoperative muscle tissue blocking,and less postoperative pain,etc.Compared with the traditional expansion channel,it is more worthy of promotion.
顾佳龙;赵敏;肖波;蔡晓敏;肖春林;杨俊;李浩;周江军
中国人民解放军联勤保障部队第九〇八医院骨科,江西 南昌,330001鹰潭市人民医院骨科,江西 鹰潭,335000中国人民解放军联勤保障部队第九〇八医院骨科,江西 南昌,330001中国人民解放军联勤保障部队第九〇八医院骨科,江西 南昌,330001赣南医科大学第一附属医院骨科,江西 赣州,341000鹰潭一八四医院骨科,江西 鹰潭,335000中国人民解放军联勤保障部队第九〇八医院骨科,江西 南昌,330001中国人民解放军联勤保障部队第九〇八医院骨科,江西 南昌,330001
医药卫生
腰椎间盘突出症通道下经椎间孔入路腰椎椎间融合术一次性13mm固定通道Quadrant扩张通道
Lumbar disc herniationLumbar interbody fusion via subchannel transforaminal approachOne-time 13 mm fixed channelQuadrant expansion channel
《生物骨科材料与临床研究》 2026 (2)
34-39,6
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