Efficacy and safety of minimally invasive percutaneous interbody fusion in the treatment of single segmental Ⅰ and Ⅱ degenerative lumbar spondylolisthesis
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摘要: 目的 探讨微创经椎间孔椎体间融合术治疗单节段Ⅰ、Ⅱ度退行性腰椎滑脱症的临床效果及安全性。 方法 选取2015年6月-2017年6月收治的单节段Ⅰ、Ⅱ度退行性腰椎滑脱症患者92例为研究对象,用随机数字表法分为对照组46例、观察组46例,对照组行常规开放手术治疗,观察组行微创经椎间孔椎体间融合术治疗,观察2组患者手术相关指标,腰椎功能、疼痛程度变化及术后并发症发生情况。 结果 观察组术中出血量、术后引流量与对照组比较,均明显较少,术后住院时间与对照组比较,明显较短,手术时间与对照组比较显著较长,差异均有统计学意义(均P<0.05);2组患者术前腰椎功能及疼痛程度差异均无统计学意义(均P>0.05),术后3个月,观察组JOA评分与对照组比较明显较高,ODI指数及VAS评分与对照组比较显著较低,差异均有统计学意义(均P<0.05);观察组术后出现1例切口感染,并发症发生率为2.17%,对照组3例切口感染、1例硬膜囊撕裂、1例融合器位置不佳,并发症发生率为17.39%,差异有统计学意义(P<0.05)。 结论 微创经椎间孔椎体间融合术治疗单节段Ⅰ、Ⅱ度退行性腰椎滑脱症可有效缓解患者疼痛,改善腰椎功能,效果显著,且能减少术中、术后出血,降低并发症发风险,值得推广。Abstract: Objective To investigate the clinical effect and safety of minimally invasive transforaminal interbody fusion in the treatment of single segment Ⅰ and Ⅱ degenerative spondylolisthesis. Methods A total of 92 patients with degenerative lumbar spondylolisthesis were selected from June, 2015 to June, 2017. They were randomly divided into 46 cases in the control group and 46 cases in the observation group.The control group was treated by conventional open surgery,and the observation group received minimally invasive transforaminal interbody fusion. The operative related indicators,lumbar function, pain degree and postoperative complications of the two groups were observed. Results Intraoperative blood loss and postoperative drainage volume in the observation group were significantly less than those in the control group. Postoperative hospitalization time was shorter than that in the control group, and the operative time was significantly longer than that in the control group. The difference was statistically significant (P<0.05). There was no significant difference in lumbar function and pain between the two groups before operation (P>0.05). After 3 months, the JOA score in the observation group was significantly higher than that in the control group,and the ODI index and VAS score were significantly lower than those in the control group. The difference was statistically significant (P<0.05). The incidence of complication was 2.17% in 1 case of incision infection, 3 cases of incision infection, 1 case of dural capsule tear, 1 case of fusion device were poor, and the incidence of complication was 17.39%, the difference was statistically significant (P<0.05). Conclusion Minimally invasive intervertebral foramen interbody fusion for treatment of single segmental Ⅰ and Ⅱ degenerative lumbar spondylolisthesis can effectively relieve pain in patients. It can reduce bleeding during operation and reduce complication risk. It is worth popularizing.
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