【摘要】 目的探讨X-tube下肌间隙入路腰椎减压内固定加椎间植骨融合治疗腰椎管狭窄的可行性及疗效。方法 2010年3月~2011年10月在X-tube下经肌间隙入路行腰椎减压内固定加椎间植骨融合治疗椎管狭窄32例。术前、术后1月及末次随访时采用ODI及VAS评估患者疗效,并在X线片上观察患者椎间隙高度及植骨融合情况。结果本组手术平均时间60(55~70)min;手术切口平均长度3.5(3~5)cm;术中出血量平30(20~50)ml;平均住院时间6.5(6~7)d。术中无硬脊膜损伤发生。32例患者均获得随访,平均21.6(12~31)个月。手术切口均Ⅰ期愈合,无术后感染发生。术前、术后1个月及末次随访ODI评分分别为38.96±1.68、16.28±3.12和3.60±1.40,VAS评分分别为7.16±0.78、2.56±0.76和1.04±0.70,三者比较均有统计学差异(P<0.01)。术后1月和末次随访时椎间隙高度分别为(13.48±0.56)mm和(12.41±0.87)mm,较术前(8.86±0.79)mm均有统计学差异(P<0.01)。结论 X-tube下经肌间隙入路是一种安全有效的微创手术入路,经该入路行腰椎减压内固定加植骨融合术治疗腰椎管狭窄可取得满意的临床疗效。更多还原

【Abstract】 Objective To study the feasibility and the outcome of X-tube system used in pedicle screw fixation,decompression and interbody fusion through spatium intermusculare approach for treatment of lumbar spinal canal stenosis.Methods From March 2010 to October 2011,32 cases of spinal canal stenosis were performed the surgery of pedicle screw fixation,decompression and interbody fusion via spatium intermusculare approach under X-tube system.The preoperative,1 month postoperative and latest follow-up functional evaluation were evaluated with ODI and VAS system.The fusion status and the height of the intervertebral space were measured according to X-ray plates.Results The surgery duration was 55 to 70 minutes( mean 60),the incision length was 3 to 5 cm( mean 3.5),the intraoperative blood loss was 20 to 50 ml( mean 30) and the hospitals stay was 6 to 7 days( mean 6.5).No dural mater injuries occurred.All 32 cases were followed up for 12 to 31 months with an average of 21.6 months.All incisions were healing in stage Ⅰ without infection after the surgery.The ODI scores of preoperative,1 month postoperative and latest follow-up were 38.96 ± 1.68,16.28 ± 3.12 and 3.60 ± 1.40 respectively,while the VAS scores were 7.16 ± 0.78,2.56 ± 0.76 and 1.04 ± 0.70,there was statistic difference among them( P < 0.01).The intervertebral space of 1 month and latest follow-up was 13.48 ± 0.56 and 12.41 ± 0.87,both were obviously enlarged than 8.86 ± 0.79 of preoperation( P <0.01).Conclusions Spatium intermusculare approach is a safe and effective minimal invasive operative route for X-tube technique.The surgery of pedicle screw fixation,decompression and interbody fusion under X-tube system via spatium intermusculare approach can achieve satisfactory curative effect for the treatment of lumbar spinal canal stenosis.更多还原