Wiltse入路经椎间孔腰椎椎体间融合术治疗腰椎间盘退行性病变的效果

Effect of Wiltse Approach for Transforaminal Lumbar Interbody Fusion in the Treatment of Degenerative Change of Lumbar Intervertebral Disc

目的:探究Wiltse入路经椎间孔腰椎椎体间融合术治疗腰椎间盘退行性病变的效果。方法:将2019年1月-2022年11月中国航天科工集团七三一医院收治的100例腰椎间盘退行性病变患者根据随机数字表法分为两组。对照组(n=50)采用经传统入路经椎间孔腰椎椎体间融合术治疗,观察组(n=50)采用Wiltse入路经椎间孔腰椎椎体间融合术治疗。比较两组术中出血量、术后引流量、术后住院时间,治疗前后的腰椎及下肢疼痛情况[视觉模拟评分法(VAS)]、功能状态[Oswestry功能障碍指数(ODI)]及腰椎相关参数(患椎椎间隙高度及腰椎前凸角)。结果:观察组术中出血量及术后引流量均显著少于对照组,术后住院时间显著短于对照组,差异均有统计学意义(P<0.05)。术前两组腰椎及下肢VAS评分、ODI及腰椎相关参数比较,差异均无统计学意义(P>0.05);术后1、3个月,观察组腰椎及下肢VAS评分及ODI均显著优于对照组,腰椎相关参数均显著高于对照组,差异均有统计学意义(P<0.05)。结论:Wiltse入路经椎间孔腰椎椎体间融合术在腰椎间盘退行性病变中的疗效较好,可显著改善患者的腰椎功能及椎体参数,加快术后康复。

Objective:To investigate the effect of Wiltse approach for transforaminal lumbar interbody fusion in the treatment of degenerative change of lumbar intervertebral disc.Method:A total of 100 patients with degenerative change of lumbar intervertebral disc admitted to China Aerospace Science and Industry Group 731 Hospital from January 2019 to November 2022 were divided into two groups according to random number table method.The control group(n=50)was treated with traditional approach for transforaminal lumbar interbody fusion,while the observation group(n=50)was treated with Wiltse approach for transforaminal lumbar interbody fusion.The intraoperative bleeding volume,postoperative drainage,postoperative hospitalization time,before and after treatment of lumbar and lower limb pain[visual analogue scale(VAS)],functional status[Oswestry dysfunction index(ODI)]and lumbar related parameters(intervertebral space height and lumbar lordosis)were compared between the two groups.Result:The intraoperative bleeding volume and postoperative drainage in the observation group were significantly less than those in the control group,and the postoperative hospitalization time was significantly shorter than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in VAS scores,ODI and lumbar related parameters between the two groups before operation(P>0.05).1 and 3 months after operation,the VAS scores of lumbar vertebrae and lower limb and ODI in the observation group were significantly better than those in the control group,and the related parameters of lumbar vertebrae were significantly higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Wiltse approach for transforaminal lumbar interbody fusion is effective in the treatment of degenerative change of lumbar intervertebral disc,which can significantly improve the lumbar function and vertebral body parameters of patients and accelerate postoperative rehabilitation.