【摘要】 目的对比Mast Quadrant微创系统下经椎间孔椎间融合术(Mini-TLIF)与传统开放经椎间孔椎间融合术(Open-TLIF)治疗腰椎滑脱症的临床疗效。方法回顾分析40例单节段腰椎滑脱症患者,Quadrant后路微创撑开系统辅助下行经椎间孔椎间融合术20例为微创组,开放腰椎后路经椎间孔椎间融合术20例为开放组。收集患者围手术期的资料,包括切口长度、术中出血量、引流量、手术时间和术后下床活动时间等。对所有患者术前、术后2周、2个月、1年、2年进行VAS及ODI评分并记录。比较微创组与开放组患者之间的疗效。结果微创组在切口长度、出血量、术后下床活动时间等方面优于开放组,差异有统计学意义(P<0.01);但微创组手术时间长于开放组(P<0.05)。两组患者术后VAS、ODI评分均呈下降趋势,术后各时点评分与术前比较差异均具有统计学意义(P<0.01)。微创组术后VAS、ODI评分下降幅度较开放组下降幅度大,差异具有统计学意义(P<0.01)。术后2周VAS、ODI评分,微创组优于开放组(P<0.01)。结论 Mast Quadrant微创系统下经椎间孔椎间融合术与开放腰椎后路经椎间孔椎间融合术比较,具有切口小、术中及术后出血量少、术后下床活动时间早、短期临床疗效显著等优点。只要严格掌握手术适应证,该项微创技术值得临床推广。更多还原

【Abstract】 Objective To compare the clinical efficacy of transforaminal lumbar interbody fusion via Quadrant minimally invasive system( mini-TLIF) versus traditional open transforaminal lumbar interbody fusion( openTILF) in the lumbar spine spondylolisthesis. Methods This was a retrospective review of collected data. Between January 2010 and January 2012,40 patients with low-grade spondylolisthesis were operated in our hospital,20 patients underwent open-TILF and 20 patients underwent mini-TLIF. The blood loss,length of cut,operating time,postoperative bedrid time in the two groups were recorded perioperatively. Pain and functional disability were measured using visual analogue scale( VAS) and oswestry disability index( ODI) before operation,at 2 weeks,2 months,1 year and 2years after operation. The therapeutic effects were compared between two groups after operations. Results In aspect of the blood loss,length of cut,postoperative bedrid time,the mini-TLIF group was better( P < 0. 01),while the openTILF group was better in the operating time( P < 0. 05). Postoperative VAS and ODI scores in two groups were declining after operation,each point scores were statistically significant difference( P < 0. 01) compared with preoperative scores. The postoperative VAS and ODI scores in mini-TLIF group decreased more markedly than those in the openTILF group,the difference was statistically significant( P < 0. 01). The scores of VAS and ODI of mini-TLIF group were less than those in open-TILF group at 2 weeks and 2 months after operation( P < 0. 01). Conclusion The transforaminal lumbar interbody fusion operation by Quadrant system to treat the patients with lumbar spondylolisthesis is more simple and efficient than open TILF. It has advantages in the blood loss,length of cut,postoperative bedrid time and the short-term postoperative pain. Provided strictly master the operation indications,it is worth to be promoted.更多还原