摘要
目的总结经皮微创经椎间孔腰椎椎体间融合术(MIS-TLIF)治疗腰椎退行性疾病的并发症,评估其临床疗效和安全性。方法自2010-05—2011-05采用MIS-TLIF治疗腰椎退行性疾病100例,记录手术时间、出血量、术后下床活动时间、住院时间和手术相关并发症;临床疗效评估采用VAS评分和腰椎JOA功能评分。结果随访时间18~36个月,平均23个月。手术时间95~195 min,平均125 min;出血量150~380 ml,平均210 ml;下床时间5~10 d,平均7 d,住院时间4~15 d,平均7 d;VAS评分由术前5~10分降低到末次随访时0~5分;JOA评分由术前的6~21分提高到术后23~29分;JOA评分改善率43%~92%,平均79%。2.5%(11/435)发生螺钉位置不良,1.7%(2/120)出现cage位置不良;0.8%(1/120)发生cage再移位;0.8%(1/120)的患者需要输血;2%(2/100)出现深静脉血栓;所有患者均未出现手术部位感染和脑脊液漏。结论采用MIS-TLIF治疗腰椎退行性疾病安全、可靠,并发症较低。
Objective To summarize complications of the minimally invasive percutaneous transforaminal lumbar interbody fusion(MIS-TLIF) for treatment of lumbar degenerative diseases, and assess the clinical outcomes and safety. Methods Between May 2010 and May 2011, 100 patients with lumbar degenerative diseases were treated using MIS-TLIF. The operative time, blood loss, postoperative ambulation time,the length of hospital and surgery-related complications were recorded; clinical outcomes were assessed using the VAS and JOA functional scores. Results The mean follow-up was 23months(18-36 months). The mean operative time, bleeding volume, ambulation time, and the length of hospital were 125 min(95-195 min), 210 ml(150-380 ml), 7 days(5-10 days), and 7 days(4-15 days), respectively. The VAS score improved from preoperative 5-10 points to postoperative 0-5 points; JOA score improved from preoperative 6-21 points to postoperative 23-29 points. The mean JOA improvement rate was 79%(43%-92%). The complications included 2.5%(11/435) screw malposition, 1.7%(2/120) cage malposition, 0.8%(1/120) post-operative cage migration, 0.8%(1/120) of patients requiring transfusions, 2%(2/100) appears deep vein thrombosis. No patients experienced surgical site infection and cerebrospinal fluid leakage. Conclusion The rate of complications from MIS-TLIF is low, which is a safe and effective surgery.
出处
《中国骨与关节损伤杂志》
2015年第3期269-271,共3页
Chinese Journal of Bone and Joint Injury
关键词
微创脊椎手术
经椎间孔腰椎椎体间融合术
手术相关并发症
Minimally invasive spine surgery
Transforaminal lumbar interbody fusion
Surgery-related complication