微创通道系统辅助下经多裂肌最长肌间隙入路治疗腰椎滑脱

Transforaminal lumbar interbody fusion via Luxor system in the treatment of lumbar spondylolisthesis

目的探讨微创通道系统辅助下经多裂肌最长肌间隙入路治疗腰椎滑脱的临床疗效。方法经椎间孔腰椎间融合术(TLIF)治疗88例腰椎滑脱患者,随机分为观察组(行微创TLIF)和对照组(行开放TLIF),每组44例。比较两组治疗效果。结果术中出血量、切口长度、引流量、住院时间观察组均显著少(小)于对照组(P <0. 05)。手术时间两组比较差异无统计学意义(P> 0. 05)。患者均获得随访,时间12～15个月。术后6个月融合率:观察组为54. 5%,对照组为45. 5%,差异无统计学意义(P> 0. 05)。功能评分:两组术后均较术前明显改善(P <0. 05),术后3个月观察组显著高于对照组(P <0. 05),术后12个月两组比较差异均无统计学意义(P> 0. 05)。两组患者术后影像学指标和不良反应发生率比较差异无统计学意义(P> 0. 05)。结论微创TLIF能够有效改善腰椎滑脱患者症状,纠正腰椎滑脱畸形,重建脊柱稳定性,是治疗腰椎滑脱症患者可行的手术方式。

Objective To invesigate the clinical curative effect of transforanfinal lumbar interbody fusion （TLIF） via Luxor system in the lumbar spondylolisthesis surgery. Methods The 88 patients with lumbar spondylolisthesis treated with TLIF were randomly divided into observation group （ treated with minimally invasive TLIF） and control group （ treated with open TLIF） , each group of 44 cases. The clinical efficacy was compared. Results The volume of intr-aoperative bleeding, length of incision, drainage volume and the length of stay in observation group were significantly lower than control group （ P 〈 0. 05 ）, the operation time of two groups had no difference （ P 〉 0. 05 ）. All patients were followed up for 12 - 15 months, the fusion rate at 6 months postoperatively in observation group was 54. 5% , control group was 45.5% ,with no statistically significant difference （P 〉 0. 05 ）. Both groups got improvenlent and the functional scores of observation group were significantly higher than control group at postoperative 3 months （ P 〈 0. 05 ） , which had no difference at 12 months postoperation （ P 〉 0. 05 ） ; there were no differences in imaging fea-tures and incidence rate of adverse reaction between the two groups （ P 〉 0. 05 ）. Conclusions Minimally invasive TLIF can effectively improve the symptoms of patients with lumbar spondylolisthesis, which can correct spondylolis-thesis, and reconstruct spinal stability, which is a feasible surgical procedures for treatment of spondylolisthesis.