钟睿;王润生;刘建恒;姜威;刘庆祖;毛克亚;

• 1:中国人民解放军总医院第一医学中心骨科
• 2:成都体育学院附属体育医院脊柱外科

摘要(Abstract)：

[目的]探讨双侧可扩张通道下经椎间孔椎间融合术(MIS-TLIF)治疗单节段峡部裂性腰椎滑脱症的可行性及临床疗效。[方法]回顾分析2015年9月~2017年8月,采用双侧可扩张通道辅助下MIS-TLIF治疗的单节段峡部裂性腰椎滑脱症患者21例,男9例,女12例,其中MeyerdingII度滑脱16例,III度滑脱5例。记录手术时间、术中出血量、术后住院时间、并发症情况,采用疼痛视觉模拟评分(visual analogue scores, VAS)、Oswestry障碍指数(Oswestry disability index, ODI),以及影像测量滑脱率、局部矢状位Cobb角变化评价临床结果。[结果] 21例患者手术顺利,平均手术时间(202.38±28.31) min,术中出血量(242.86±89.84) ml,2例术中硬膜撕裂,均予一期硬脊膜缝合,未出现脑脊液漏及切口不愈合,未出现置钉相关神经损伤,两组均未出现感染及术后非症状侧根性症状加重,术后住院时间(4.52±1.94) d。术前腰痛VAS (6.67±1.32)分,末次随访(2.10±1.04)分,术前腿痛(6.76±1.76)分,末次随访(0.67±0.73)分,ODI术前(52.19±13.09)%,末次随访(14.72±6.20)%,局部Cobb角从术前(10.40±9.26)°到末次随访(19.04±3.74)°,滑脱率从术前(39.86±13.11)%到末次随访(6.57±4.15)%,末次随访时,BridwellI级14例、II级7例,未出现椎弓根螺钉断裂。[结论]采用双侧可扩张通道辅助下经椎间孔椎体间融合术治疗单节段峡部裂性腰椎滑脱症,创伤小,且安全有效,值得临床推广。

关键词(KeyWords)： 腰椎滑脱症;微创手术;减压;脊柱融合术

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目（编号：51772328/81702121）;; 成都市卫生发展科研专项项目（编号：2018-4-5014）;; 成都体育学院运动医学与健康研究所创新课题（编号：CX19A05）

作者(Author): 钟睿;王润生;刘建恒;姜威;刘庆祖;毛克亚;

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参考文献(References)：

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