Zero通道下MISS TLIF联合Zina钉治疗腰椎间盘突出症

MISS TLIF under Zero channel combined with percutaneous vertebral arch screw (Zina screw) for degenerative lumbar disc herniation

目的：探讨Zero通道下微创经椎间孔入路行椎管减压、椎间融合（ MISS TLIF）联合Zina钉治疗腰椎间盘突出症的临床疗效。方法对55例腰椎间盘突出症患者采用后路切口经多裂肌肉间隙入路、经Zero 通道下行MISS TLIF联合Zina钉技术治疗。其中单侧减压49例，双侧减压5例，单侧入路双侧减压1例。采用Nakai分级评定临床疗效。结果患者均获得随访，时间6-18个月。患者腰痛和下肢放射性麻木等临床症状均有效缓解，临床疗效按Nakai分级评定：优25例，良29例，可1例，优良率为98．18%。结论 Zero通道下MISS TLIF联合Zina钉治疗腰椎间盘突出症能显著缓解患者症状，改善功能，近期疗效好。

Objective To investigate the clinical effect of minimally invasive surgery transforaminal lumbar interbody fusion （ MISS TLIF） under Zero channel combined with percutaneous vertebral arch screw （ Zina screw） in the treat-ment of degenerative lumbar disc herniation. Methods Fifty-five patients with degenerative lumbar disc herniation underwent spinal canal decompression, intervertebral bone grafting and Zina screw fixation assisted by Zero channel with the posterior multifidus muscle gap approach, including 49 cases of unilateral decompression, 5 cases of bilateral decompression and 1 case of bilateral decompression with single incision. Nakai criteria was used to evaluate the clin-ical outcomes. Results The follow-up period ranged 6-18 months in 55 patients. The clinical symptoms of patients with low back pain and leg radioactive numb were effectively alleviated at last follow-up. There were 25 cases of ex-cellent, 29 cases of good and 1 case of fair according to Nakai criteria, with total successful rate up to 98. 18%. Conclusions MISS TLIF under Zero channel combined with percutaneous Zina screw can significantly relieve the symptoms of patients and improve function. The short-term clinical outcomes in patients who are treated with MISS TLIF under Zero channel combined with percutaneous Zina screw are good.