X-tube通道下经椎间孔入路腰椎椎体间融合术治疗腰椎退行性疾病

Transforaminal lumbar interbody fusion through X-tube channel in treatment of lumbar degenerative disease

目的：探讨X-tube通道下经椎间孔入路腰椎椎体间融合术治疗腰椎腰椎退行性疾病的疗效。方法在X-tube通道下经椎间孔入路行腰椎体间植骨融合、椎弓根钉固定术治疗单节段腰椎间盘突出伴腰椎不稳症及以神经根管狭窄为主的腰椎管狭窄，盘源性腰痛等腰椎退行性疾病的患者13例。结果本组13例患者手术顺利，手术时间平均150 min；术中失血量平均210 ml；住院时间6～14 d（平均8 d）；无神经损伤，无中转开放手术。无伤口感染。ODI评分术前平均为48．3％，术后3个月平均为16．5％，术后6个月平均为14．0％，优良率97．5％。融合率100％。结论 X-tube通道下经椎间孔入路腰椎椎体间融合术对单节段腰椎间盘突出伴腰椎不稳症、以神经根管狭窄为主的腰椎管狭窄及盘源性腰痛等腰椎退行性疾病，短期疗效满意。较传统TLIF手术，具有切开小，创伤小，出血少，固定可靠，术后患者早期下床活动等优点。但是长期疗效还有待进一步随访。

Objective To investigate the effect of transforaminal lumbar interbody fusion （ TLIF） through X-tube channel in treatment of lumbar degenerative disease .Methods 13 cases of patients with lumbar degenerative disease underwent TLIF through X-tube channel and pedicle screw fixation .Results The operations went through successfully ,with average operation time of 150min,average intra-operative blood loss of 50 ml and hospitalization time of 6~14d （average 8d）.No neurological damage,conversion to open surgery or wound infection occurred .The average preoperative ODI score was 48.3%,but 3 months later the average was 16.5%,and 6 months later 14.0%.The excellent rate was 97.5%and fusion rate 100%.Conclusion TLIF through X-tube channel X-tube channel in treatment of lumbar degenerative disease has satisfactory short -term effect.It is characterized by small incision ,fewer traumas ,less bleeding ,reliable fixation and early ambulation .But long-term effect needs to be tested by further follow-up.