小切口经肌间隙入路治疗腰椎管狭窄症的临床观察(1)
【摘要】 目的：探讨小切口经肌间隙入路治疗腰椎管狭窄症的可行性及临床疗效。方法：选取2013年1-2014年1月本院收治的腰椎管狭窄患者56例作为研究对象，在X-tube下经肌间隙入路进行腰椎减压内固定、椎间植骨融合术，运用VAS与ODI对疗效进行评估，并于X线片上对椎间隙高度、植骨融合状况进行观察。结果：56例患者平均手术时间(57.5±3.4)min；手术切口平均长度(3.2±0.4)cm；术中平均出血量(28.5±3.7)mL；平均住院时间(6.3±1.1)d；术中未发生硬脊膜损伤。56例患者术后1月以及末次随访的VAS、ODI评分及椎间隙高度均优于术前，末次随访的VAS、ODI评分及椎间隙高度均低于术后1个月，比较差异均有统计学意义(P<0.05)。结论：小切口经肌间隙入路在腰椎管狭窄的临床治疗中安全度较高且效果显著，可于临床中推广应用。
【关键词】 腰椎管狭窄； 肌间隙入路； 小切口； 临床疗效
Clinical Observation of Mini-incision Wiltse Approach in the Treatment of Lumbar Spinal Stenosis/XIE Jing-bo，WU Li-ting，YAN Yi-yun.//Medical Innovation of China，12(34)：032-035
, 百拇医药
【Abstract】 Objective：To explore the feasibility and clinical efficacy of mini-incision wiltse approach in the treatment of lumbar spinal stenosis.Method：56 patients with lumbar spinal stenosis in our hospital from January 2013 to January 2014 were selected as the research objects.They were given lumbar spinal decompression and internal fixation，transforaminal lumbar interbody fusion through wiltse approach under X-tube.The efficacy was evaluated by VAS and ODI.The height of fused segment and the situation of bone graft fusion on the x-ray films were observed.Result：Among the 56 patients，the mean operative time was (57.5±3.4)min，their average length of incision was (3.2±0.4)cm，their average intraoperative blood loss was (28.5±3.7)mL and their mean duration of stay was (6.3±1.1)d.Dural injury did not occur during the operation.The scores of VAS and ODI，the height of fused segment of the final follow-up and one month after the operation were better than those before treatment，the scores of VAS，ODI and the height of fused segment of the final follow-up were lower than those one month after the operation，the differences were statistically significant(P<0.05).Conclusion：Mini-incision wiltse approach in the treatment of lumbar spinal stenosis has higher degree of safety and its effect is significant.Therefore，it can be generalized in clinical application.
, 百拇医药
【Key words】 Lumbar spinal stenosis； Wiltse approach； Small incision； Clinical effect
First-author’s address：The People’s Hospital of Fengcheng City，Fengcheng 331100，China
doi：10.3969/j.issn.1674-4985.2015.34.010
随着我国老龄化人口比例的日渐提高，腰椎管狭窄症、腰椎间盘突出症等腰椎退变性疾病也发展成当前骨科临床上极为常见的疾病[1]。若保守治疗效果不明显时往往需进行手术治疗。传统的后路腰椎间融合术(PLIF)因其会对患者脊柱后柱的结构造成破坏并对椎旁软组织产生长时间的剥离牵拉，部分病人在术后极易出现顽固性腰背痛，这就在很大程度上降低了这部分患者的手术获益。从PLIF发展到经椎间孔椎体间融合术(TLIF)，其中，微创已逐渐发展成手术治疗腰椎退变性疾病的潮流[2]。选取2013年1月-2014年1月本院收治的腰椎管狭窄患者56例为本次研究对象，就X-tube复制下小切口经肌间隙入路在腰椎管狭窄术中进一步降低手术损伤的可行性及临床疗效进行探讨，现报告如下。, 百拇医药(谢静波 伍俐亭 鄢义云)
【关键词】 腰椎管狭窄； 肌间隙入路； 小切口； 临床疗效
Clinical Observation of Mini-incision Wiltse Approach in the Treatment of Lumbar Spinal Stenosis/XIE Jing-bo，WU Li-ting，YAN Yi-yun.//Medical Innovation of China，12(34)：032-035
, 百拇医药
【Abstract】 Objective：To explore the feasibility and clinical efficacy of mini-incision wiltse approach in the treatment of lumbar spinal stenosis.Method：56 patients with lumbar spinal stenosis in our hospital from January 2013 to January 2014 were selected as the research objects.They were given lumbar spinal decompression and internal fixation，transforaminal lumbar interbody fusion through wiltse approach under X-tube.The efficacy was evaluated by VAS and ODI.The height of fused segment and the situation of bone graft fusion on the x-ray films were observed.Result：Among the 56 patients，the mean operative time was (57.5±3.4)min，their average length of incision was (3.2±0.4)cm，their average intraoperative blood loss was (28.5±3.7)mL and their mean duration of stay was (6.3±1.1)d.Dural injury did not occur during the operation.The scores of VAS and ODI，the height of fused segment of the final follow-up and one month after the operation were better than those before treatment，the scores of VAS，ODI and the height of fused segment of the final follow-up were lower than those one month after the operation，the differences were statistically significant(P<0.05).Conclusion：Mini-incision wiltse approach in the treatment of lumbar spinal stenosis has higher degree of safety and its effect is significant.Therefore，it can be generalized in clinical application.
, 百拇医药
【Key words】 Lumbar spinal stenosis； Wiltse approach； Small incision； Clinical effect
First-author’s address：The People’s Hospital of Fengcheng City，Fengcheng 331100，China
doi：10.3969/j.issn.1674-4985.2015.34.010
随着我国老龄化人口比例的日渐提高，腰椎管狭窄症、腰椎间盘突出症等腰椎退变性疾病也发展成当前骨科临床上极为常见的疾病[1]。若保守治疗效果不明显时往往需进行手术治疗。传统的后路腰椎间融合术(PLIF)因其会对患者脊柱后柱的结构造成破坏并对椎旁软组织产生长时间的剥离牵拉，部分病人在术后极易出现顽固性腰背痛，这就在很大程度上降低了这部分患者的手术获益。从PLIF发展到经椎间孔椎体间融合术(TLIF)，其中，微创已逐渐发展成手术治疗腰椎退变性疾病的潮流[2]。选取2013年1月-2014年1月本院收治的腰椎管狭窄患者56例为本次研究对象，就X-tube复制下小切口经肌间隙入路在腰椎管狭窄术中进一步降低手术损伤的可行性及临床疗效进行探讨，现报告如下。, 百拇医药(谢静波 伍俐亭 鄢义云)