| 陆焱,云雄,梁昌海,等.微创经椎间孔腰椎椎间融合术治疗老年不稳定性椎管狭窄的效果[J].中国临床保健杂志,2019,22(5):701-706. |
| 微创经椎间孔腰椎椎间融合术治疗老年不稳定性椎管狭窄的效果 |
| Effect of Mis-TLIF fixation technique on unstable spinal canal stenosis in the elderly and follow-up |
| 投稿时间：2019-06-18 |
| DOI：10.3969/J.issn.1672-6790.2019.05.035 |
| 中文关键词: 椎管狭窄 不稳定性 治疗结果 预后 老年人 |
| 英文关键词: Spinal stenosis Instability Treatment outcome Prognosis Aged〖FL |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨微创经椎间孔腰椎椎间融合术(Mis-TLIF)用于老年不稳定性椎管狭窄的疗效,并对其随访结果进行分析。方法 回顾性分析行老年不稳定性椎管狭窄根治术的102例患者病历资料。按照手术方法分为Coflex组(n=47)和Mis-TLIF组(n=55)。Coflex组采用开放TLIF进行治疗,而Mis-TLIF组则采用固定通道下Mis-TLIF治疗,术后进行为期1年时间的随访。分别比较两组患者术中和术后相关数据,术后1月及末次随访时疗效,术前、术后1月以及末次随访时腰部和下肢的视觉模拟疼痛评分(VAS)、Oswest功能障碍指数(ODI)以及生存质量简表(WHOQOI-BREF),术前及末次随访时影像学相关指标,术后及随访期间并发症以及复发率之间的差异。结果 Mis-TLIF组手术时间长于Coflex组,而术中出血量及术后引流量低于Coflex组(P＜0.05)。末次随访时Mis-TLIF组优良率显著高于Coflex组(P＜0.05)。Mis-TLIF组的腰部和下肢VAS评分,术后1月及末次随访时,和Coflex组相比均明显下降,差异有统计学意义(P＜0.05)。Mis-TLIF组的ODI和WHOQOI-BRE评分,术后1月及末次随访时,ODI和Coflex组相比均明显下降,WHOQOI-BREI和Coflex组相比均明显升高,差异有统计学意义(P＜0.05)。Mis-TLIF组的所有影像学资料,术前均和Coflex组相近,而术后1月及末次随访时,所有影像学资料和Coflex组相比均明显升高,差异有统计学意义(P＜0.05)。两组患者并发症人数及症状复发人数比较,差异无统计学意义(P均＞0.05)。结论 Mis-TLIF技术能有效治疗老年不稳定性椎管狭窄,并提升远期疗效,在有效改善患者远期疼痛及功能障碍的同时,促进患者生活质量提高,且安全性较好。 |
| 英文摘要: |
| Objective To explore the effect of Mis-TLIF fixation technique on unstable spinal canal stenosis in the elderly.Methods A retrospective analysis of the clinical data of 102 elderly patients with unstable spinal canal stenosis undergoing surgery were carried out.The patients were divided into Coflex group (n=47) and mis-tlif group (n=55) according to surgical methods.The Coflex group was treated with open translaminar lumbar interbody fusion,while the Mis-TLIF group was treated with minimally invasive transforaminal lumbar interbody fusion(Mis-TLIF).The patients were followed up for 1 year.The intraoperative and postoperative data,the efficacy at 1 month and the last follow-up,and the visual analog pain score(VAS) and Oswest dysfunction index(ODI) of the lower and lower limbs,and quality of life profile(WHOQOI-BREF),imaging-related index at preoperative and last follow-up,complications and recurrence rates of postoperative and follow-up of the two groups were compared.Results The operation time of the Mis-TLIF group was significantly longer than that of the Coflex group,and the intraoperative blood loss and postoperative drainage volume were significantly lower than those of the Coflex group (P<0.05).The excellent rate of Miss-TLIF group was significantly higher than that of Coflex group at the last follow-up(P<0.05).The VAS scores of the lumbar and lower limbs in the Mis-TLIF group were similar to those in the Coflex group preoperatively,and were significantly lower than those in the Coflex group at 1 month and at the last follow-up.The difference was statistically significant (P<0.05).The ODI and WHOQOI-BRE scores of the Mis-TLIF group were similar to those of the Coflex group preoperatively,the ODI was significantly lower and the WHOQOI-BREI was significantly higher than those in the Coflex group at 1 month and at the last follow-up.The difference was statistically significant (P<0.05).All imaging data in the Mis-TLIF group were similar to those in the Coflex group preoperatively,and all imaging data were significantly higher than those in the Coflex group at 1 month and at the last follow-up.The difference was statistically significant (P<0.05).There was no significant difference in the number of complications and the number of recurrences between the two groups (P>0.05).Conclusion Mis-TLIF fixation technology can effectively treat unstable spinal canal stenosis in the elderly and improve long-term outcomes.It can improve patients′ long-term pain and dysfunction with better quality of life. |
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