内窥镜下退变性腰椎失稳微创外科治疗的临床研究

Clinical Study on Minimally Invasive Surgical Treatment of Degenerative Lumbar Instability under Endoscopy

目的研究内窥镜下退变性腰椎失稳微创外科治疗的方法。方法运用METRXX-Tube微创手术系统结合螺纹式Cage对16例腰椎失稳患者进行减压、融合内固定,并与开放手术组作影像、实验室、ODI指数对比分析。结果 16例患者腰腿疼痛较术前明显缓解或消失,术后第2、12周及期末ODI评分均优于开放手术组,优良率97.5%(P<0.01),术后X线片及CT复查见椎间隙高度较术前明显改善,切口、失血量、住院天数、实验室指标结果其差异具有统计学意义(P<0.01)。结论该方法切口小,术中软组织剥离轻,出血少,术后疼痛轻、恢复快,但手术时间长,X射线量大,操作难度较高,应严格掌握适应证。

Objective To research the minimally invasive surgical treatment of degenerative lumbar instability under endoscopy. Methods 16 patients with lumbar instability received METRX X-Tube minimally invasive operation system under the combination of screw type Cage for decompression, fusion and internal fixation. The comparative analysis of imaging, laboratory, ODI index compared with open operation group were carried out. Results The back and leg pain was improved or resolved in 16 patients; 2 weeks, 12 weeks after the operation, the ODI scores were better than the open operation group; the excellent and good rate was 97.5% （P 〈0.01）. The postoperative height of intervertebral space detected by X-ray and CT reexamination was obviously improved compared with preoperation. The differences of incisions, blood loss, length of hospital stay, laboratory results were statistically significant （P 〈0.01）. Conclusions The method has the advertages of small incision, mild stripping of the soft tissue, less bleeding, fast recovery, and the disadvertages of long operation time, large X-ray amount, high difficulty of operation, so the indications should be strictly controlled.