机器人导航内镜下经椎间孔入路椎间融合术治疗腰椎间盘突出症

Robot-guided endoscopic assisted transforaminal interbody fusion for lumbar disc herniation

目的探讨应用机器人导航内镜下经椎间孔入路椎间融合术治疗腰椎间盘突出症的临床疗效。方法将98例腰椎间盘突出症患者根据治疗方法不同分为观察组(32例,采用机器人导航内镜下经椎间孔入路椎间融合术治疗)与对照组(66例,采用后路腰椎椎间融合术治疗)。记录手术时间、术中出血量、术后引流量、住院时间及并发症发生情况,采用疼痛VAS评分评价疼痛改善情况,采用ODI评分评价脊柱功能。结果患者均获得随访,时间12~22个月。手术时间观察组长于对照组(P<0.01)。术中出血量、术后引流量及住院时间观察组均少(短)于对照组(P<0.01)。两组并发症发生率比较差异无统计学意义(P>0.05)。两组术后1周及1、3、6、12个月疼痛VAS评分、ODI均较术前降低(P<0.05);观察组均低于对照组(P<0.01)。结论采用机器人导航内镜下经椎间孔入路椎间融合术治疗腰椎间盘突出症创伤小,疼痛改善情况好,脊柱功能恢复快。

Objective To investigate the clinical effect of transforaminal lumbar interbody fusion(TLIF)under the application of robot navigation combined with endoscopy in the treatment of lumbar disc herniation.Methods The 98 patients with lumbar disc herniation who underwent surgical treatment were divided into observation group(32 cases,using TLIF under the application of robot navigation combined with endoscopy)and control group(66 cases,using posterior lumbar interbody fusion technique),according to different treatment methods.Operation duration,intraoperative blood loss,postoperative drainage volume,length of hospital stay and complications were recorded.Pain VAS was used to evaluate the improvement of pain,and ODI was used to evaluate spinal function.Results All patients were followed up for 12~22 months.The operation duration in observation group was longer than that of control group(P<0.01).The intraoperative blood loss,postoperative drainage volume and length of hospital stay in the observation group were less(shorter)than those in the control group(P<0.01).There was no statistical significance in the incidence rate of complications between the two groups(P>0.05).The pain VAS and ODI in both groups were decreased at 1 week,1,3,6,12 months after surgery than the preoperation(P<0.05).Observation group was lower than the control group(P<0.01).Conclusions Robot-guided endoscopy assisted TLIF for treatment of lumbar disc herniation is featured with less trauma,better improvement of pain and faster recovery of spinal function.