小切口TLIF结合半坚强内固定系统治疗腰椎椎间盘退行性疾病

Small incision TLIF combined with semi-rigid internal fixation system in the treatment of lumbar degenerative disc disease

目的探讨小切口TLIF技术结合半坚强内固定系统治疗腰椎椎间盘退行性疾病的临床疗效。方法2010年3月-2011年3月对21例腰椎椎间盘退行性疾病患者行后路小切口TLIF结合半坚强内固定系统，全部患者使用后正中切口．经肌间隙入路显露、单侧单节段BIOFIX内固定、单枚椎间CAGE（peek材料）植入，行椎管减压、椎间融合治疗腰椎椎间盘退行性疾病。记录视觉模拟评分（VAS）、Oswestry功能障碍指数（Oswestry disability index，ODI）及融合情况。结果21例患者均获随访，随访时间为12-28个月，平均随访15．6个月。术后即时及末次随访时VAS及ODI评分明显改善，与术前相比差异有统计学意义（P〈0．05），融合率为100％。结论使用后路小切口TLIF技术结合半坚强内固定系统治疗腰椎椎间盘退行性疾病是一种安全、有效的方法，它能够在提供稳定的力学环境保证椎间融合的同时，减少患者的手术创伤，促进康复，并可能避免刚性内固定引起的邻近椎间盘退变。

Objective To explore clinical efficacy of lumbar degenerative disc disease in the treatment of the small in- cision of TLIF technique combined with semi-rigid internal fixation system. Methods From March 2010 to March 2011, 21 patients who underwent a single-level transfoaminal lumbar interbody fusion with semi-rigid internal fixation system for the treatment of lumbar degenerative disc disease were studied. All patients were received a posterior mid- line incision, muscle space approach, BIOFIX internal fixation, single cage implanted. Outcome measures included the VAS, Oswestry disability index （ODI） as well as a radiographic assessment of fusion. Results All patients were fol- lowed for 12-28 months （the mean time of 15.6 months）. The postoperative difference of mean improvements in the O- DI scores and VAS were statistically significant compared with the preoperative （P 〈 0.05）. Fusion rate was 100%. Conclusion The posterior small incision TLIF technology combined with semi-rigid internal fixation system in the treatment of lumbar degenerative disc disease is a safe and effective method. It can provide a stable mechanical envi- ronment to ensure interbody fusion, reduce the patient＇s surgical trauma, avoid adjacent disc degeneration caused by the rigid internal fixation.