通道下经多裂肌间隙腰椎单边融合术的疗效观察

Observation on the effect of unilateral fusion of lumbar spondylolisthesis under the channel

目的:评估通道下经多裂肌间隙单边椎弓根钉固定减压融合术治疗腰椎间盘突出症的临床疗效。方法:2014年5月至2016年6月,选择腰椎间盘突出症的患者26例,本组男14例,女12例,年龄37—49岁,平均43.5岁,应用可扩张微创手术系统（Quadrant系统）（图1）,对18例单侧症状的腰椎间盘突出患者采用经椎旁多裂肌间隙入路单边椎弓根钉内固定,单枚cage椎间植骨融合术治疗。术后通过X线及CT观察融合情况。结果:手术均采用微创切口,长约3.2-4.3cm,平均3.7cm,术中出血约100ml-220ml,手术时间平均约65mm。随访6-11月,无断钉等情况,均获骨性融合。应用视觉模拟评分visual analogue scale（VAS）评估患者术后疼痛缓解状况。结论:采用经多裂肌间隙单边椎弓根钉固定融合术治疗腰椎间盘突出,疗效好、创伤小、出血少,但应严格把握手术适应症。

Objective:To investigate the clinical outcome of of lumbar interbody fusion with unilateral pedicle screw fixation through intra-multifidus muscle space via retractor for lumbar disc herniation.Methods:Between May 2014 and June 2016,eighteen patients with lumbar disc herniation were selected,14 males and 12 females,average ages 43.5 years,with unilateral pedicle screw fixation through intra-multifidus muscle space via Mast-Quadrant retractor.To evaluate the effect of fusion through the X Ray and CT.Result:Minimally invasive operation incision was used,the length of incision was 3.2-4.3 cm,average was 3.7 cm,the intraoperative hemorrhage is 100 ml-220 ml,the average operative time is 65 mm.The period of postoperative follow-up was 6-12 months,without nail broken,all achieved bony fusion.To evaluate the pain relief through VAS.Conclusion:The method of lumbar interbody fusion with unilateral pedicle screw fixation through intra-multifidus mulscle space via retractor for lumbar degenerative diseases was effective,minimally invasive and less blood loss.However,the indication should be rigorously assessed.