个性化数字模拟置钉结合通道下MIS-TLIF治疗相邻双节段腰椎退变性疾病

Personalized digital simulation nailing combined with channel MIS-TLIF for the treatment of adjacent dual-segmental degenerative lumbar disease

目的探讨采用个性化数字模拟置钉结合通道下MIS-TLIF治疗相邻双节段腰椎退变性疾病的疗效。方法对39例相邻双节段腰椎退变性疾病患者采用通道下MIS-TLIF手术治疗,观察患者手术时间、术中出血量、术后引流量、住院时间、术后下地行走时间。采用疼痛VAS评分、ODI评分评价疗效。结果 39例均获得随访,时间15~30个月。手术时间120~230(155.89±24.57)min;术中出血量180~490(287.94±74.59)ml;术后引流量100~280(158.46±39.04)ml;住院时间5~10(7.33±0.85)d;术后下地行走时间3~7(4.05±1.07)d。VAS评分:术前为(7.66±0.66)分,术后1周为(2.97±0.67)分,术后1个月为(1.89±0.55)分,末次随访为(1.12±0.52)分,术后各时间段与术前比较、术后1个月与术后1周比较以及末次随访与术后1个月比较差异均有统计学意义(P<0.05)。ODI评分:术前为(37.28±1.99)分,术后1个月为(16.43±1.68)分,末次随访为(12.35±1.18)分,术后各时间段与术前比较、末次随访与术后1个月比较差异均有统计学意义(P<0.05)。结论采用个性化数字模拟置钉结合通道下MIS-TLIF治疗相邻双节段腰椎退变性疾病出血少、组织破坏少、术后恢复快,疗效满意。

Objective To investigate the therapeutic effects of combination of personalized digital analog nailing and channel MIS-TLIF for the treatment of adjacent dual-segmental lumbar degenerative disease.Methods A total of 39 patients were treated with MIS-TLIF for adjacent double segments degenerative lumbar disease.The operation time , intraoperative blood loss ,postoperative drainage ,hospitalization time and the landing and walking time were observed , the VAS and ODI score were compared before and after operation ,and the curative effect was evaluated.Results All 39 cases were followed up for 15~30 months.The operation time was 120~230（155.89 ±24.57）min, intraoperative blood loss was 180~490（287.94 ±74.59） ml; postoperative drainage was 100 ~280（158.46 ±39.04）ml, hospitalization time was 5~10 （7.33 ±0.85）d, postoperative landing and ambulation time was 3~7（4.05 ±1.07） d.Preoperative VAS was 7.66 ±0.66, 2.97 ±0.67 was at 1 week after surgery , 1.89 ±0.55 was at 1 month after surgery, last follow-up was 1.12 ±0.52, there were significant differences for VAS comparison between postoperative different periods and the preoperation ,postoperative 1 month and 1 week,the last follow-up and postoperative 1 month （P〈0.05）.Preoperative ODI score was 37.28 ±1.99, 1 month after surgery was 16.43 ±1.68, last follow-up was 12.35 ±1.18,the ODI comparison was similar to VAS（P〈0.05）.Conclusions Minimally invasive interbody fusion and internal fixation for adjacent dual-segmental degenerative lumbar disease have advantages of less bleeding , less tissue damage , rapid postoperative recovery , curative effect.