微创通道下单侧TLIF联合对侧肌间隙入路置钉治疗腰椎间盘突出症疗效观察

Clinical outcome of transforaminal lumbar interbody fusion via unilateral MAST Quadrant combined with contralateral paraspinal muscle approach in treatment of lumbar disc herniation

目的探讨MASTQuadrant微创通道下单侧经椎间孔腰椎椎体间融合术（TUF）联合对侧肌间隙人路置钉治疗腰椎间盘突出症疗效观察。方法回顾性分析自2008年2月～2011年10月，采用Quadrant微创通道下单侧TLIF联合对侧肌间隙人路置钉治疗89例腰椎间盘突出症。结果手术时间90～185min，平均125．7min；术中出血量300～550ml，平均390ml；切口均一期愈合。术后随访12～28个月，平均15．2个月；末次随访VAS评分为（1．6±1．2）分，与术前比较差异有统计学意义（P〈0．05）。随访期间未见椎弓根钉内固定系统松动、断裂或移位。结论Quadrant微创通道下单侧TLIF联合对侧肌间隙人路置钉技术是一种治疗腰椎间盘突出症的安全、有效的微创手术方式。

Objective To investigate the effect of transforaminal lumbar interbody fusion via unilateral MAST Quadrant combined with contralateral paraspinal muscle approach in treatment of lumbar disc herniation. Methods From February 2008 to October 2011, 89 cases of lumbar disc herniation were treated with transforaminal lumbar interbody fusion via unilateral MAST Quadrant combined with contralateral paraspinal muscle approach. Results The operative time was 90 to 185 minutes （average 125.7 minutes） and the amount of blood loss was 300～550 ml （average 390 ml）. AH incisions healed by first intention. All patients were followed up 12～28 months （average 15.2 months）. The VAS score decreased to （1.6±1.2） points at the last follow-up, showing significant difference when compared with that before operation （P 〈0.05）. The X-ray showed that lumbar interbody fusion was achieved in all the patients. No loosening, breakage, and displacement of pedicle screw fLxation were observed. Conclusion TLIF via unilateral MAST Quadrant combined with contralateral paraspinal muscle approach is a safe, effective, and minimally invasive surgical technique in treating lumbar disc herniation.