内窥镜下后路腰椎椎体间融合椎弓根螺钉内固定术治疗退行性腰椎不稳的围手术期护理

Perioperation nursing of posterior lumbar interbody fusion device with pedicle screw fixation for lumbar vertebral degenerative instability by microendoscopic surgery

目的 探讨内窥镜下（X—tube）后路腰椎椎体间融合、椎弓根螺钉复位内固定术治疗退行性腰椎不稳的围手术期护理方法。方法 回顾性分析17例患者内窥镜下后路腰椎椎体间融合、椎弓根螺钉复位内固定术治疗退行性腰椎不稳的围手术期护理措施。结果 17例患者术程顺利，无一例患者发生神经器质性损伤，无被迫改开放式手术。围手术期发生椎间隙感染1例。17例患者获得随访，时间4～12个月，平均8．2个月，优良率97．5％。结论 内窥镜下后路腰椎椎体间融合椎弓根螺钉内固定术治疗退行性腰椎不稳，手术切口短，创伤小、出血少，术后功能恢复快，临床效果满意。充分的术前准备、密切观察术后病情变化、预防感染、加强康复训练及术后功能锻炼是提高手术成功率的重要保证。

Objective To explore the perioperative nursing methods of the posterior lumbar interbody fusion device with pedicle screw fixation for lumbar vertebral degenerative instability by microendoscopic surgery. Methods The perioperation nursing methods of Seventeen patients with lumbar vertebral degenerative instability treated with posterior lumbar interbody fusion and pedicle screw fixation by microendoscopic surgery were analyzed retrospectively. Results 17 cases were reviewed after surgery, a- mong which one case suffered from intervertebral infection. No cases converted to open operation and no nerve injury occurred during operation. The postoperative follow- up ranged from 4 months to 12 months. The rate of excellent and good was 97.5 %. Conclusions The posterior lumbar interbody fusion device with pedicle screw fixation for lumbar vertebral degenerative instability by microendoscopic surgery has the advantages of shorter skin incision, less tissue damage, less blood loss and quicker postoperative recovery. Enough preoperative preparation, and postoperative observation, and prevention of surgical wound infections and rehabilitation training are the key for satisfactory outcomes.