Quadrant系统用于腰椎滑脱治疗体会

Treatment Experience of MAST Quadrant Retractor in the Management of Lumbar Spondylolisthesis

目的:探讨经Mast Quadrant系统下微创治疗腰椎滑脱的疗效。方法:选择2010年3月-2013年1月本院峡部裂或退变型滑脱22例患者,对其实施后路经MAST Quadrant通道下植骨融合内固定手术,滑脱部位:L4～L5者10例,L5～S1者12例。术前疼痛视觉模拟(VAS)评分为(6.8±1.3)分。结果:患者手术时间平均为(160±20)min,术中出血量(320±102)ml,住院时间为(10.0±4.0)d,术后切口均呈I/甲愈合。术后X线片提示滑脱椎体均复位。患者均获随访,随访时间9～18个月,平均12.3个月。末次随访时VAS评分为(2.3±1.5)分,与术前比较差异有统计学意义(P<0.05)。X线片提示术后6个月椎体间达骨性融合,未见椎弓根螺钉内固定系统出现松动、断裂或移位。结论:经Mast Quadrant系统是治疗腰椎滑脱的一种有效的方法,具有损伤小、恢复快、并发症少的优点,疗效满意。

Objective： To investigate the efficacy and safety of minimally invasive surgical technique via MAST Quadrant retractor in the management of lumbar spondylolisthesis.Metbod： 22 patients with lumbar spondylolisthesis were treated with posterior lnmbar interbody fusion via MAST Quadrant retractor from March 2010 to January 2013, Of the total vertebraes, 10 cases were L4-5, 12 cases were Ls-SI.VAS score was used at pre- operation and final follow-up.VAS score was （ 6.8 ~ 1.3 ） points at pre-operation.Result＇： The operative time was （ 160 ~ 20 ） minutes and the amount of blood loss was （ 320 ~ 102 ） ml.The hospitalization time were （ 10.0 ~ 4.0 ） days.All incisions healed by first intention.X-ray films showed spondylolisthesis reduction immediately after operation.All patients were followed up 12.3 months on average （ from 9 to 18months ） .The VAS score decreased to （ 2.3 ＋ 1.5 ） points at the last follow-up, showing significant difference when compared with that of preoperation （ P〈0.05 ） .The X-ray films showed that lumbar interbody fusion was achieved in all the patients.No lessening, breakage, and displacement of pedicle screw fixation was observed.Conclusion： MAST Quadrant retractor is an effective and less-damage treatment for patients with lumbar spondylolisthesis with quick recovery and few complications.