目的:探讨Delta大通道内镜辅助下后路椎管减压椎间植骨融合术治疗退变性腰椎疾病的效果。方法:回顾性分析2021年9月~2022年9月我院收治的80例退变性腰椎疾病患者的病历资料,根据患者治疗方式分为观察组(38例,男17例,女21例,年龄61.0...目的:探讨Delta大通道内镜辅助下后路椎管减压椎间植骨融合术治疗退变性腰椎疾病的效果。方法:回顾性分析2021年9月~2022年9月我院收治的80例退变性腰椎疾病患者的病历资料,根据患者治疗方式分为观察组(38例,男17例,女21例,年龄61.0±4.9岁)和对照组(42例,男20例,女22例,年龄60.5±5.4岁),观察组患者采取Delta大通道内镜下Endo-PLIF治疗,对照组采取开放后路腰椎椎间融合术治疗,记录两组患者术中出血量、术后引流量、手术时间、手术切口长度、住院时间,比较患者并发症发生情况。于术前、术后1周、1个月、3个月、6个月使用视觉模拟量表(visual analogue scale,VAS)评分评估患者腰痛情况,并采用Oswestry功能障碍指数(Oswestry disability index,ODI)评估患者腰椎功能;使用改良Macnab标准对患者进行疗效评估。根据患者术后1年随访时的腰椎影像学复查结果,使用Bridwell椎间融合标准对患者手术节段融合情况进行评估。结果:观察组患者的术中出血量及术后引流量分别低于对照组(88.46±10.98mL vs 112.99±12.01mL、159.73±18.42mL vs 201.36±23.06mL,P<0.05),手术切口及住院时间分别短于对照组(1.54±0.36cm vs 5.43±1.01cm、6.79±1.22d vs 8.03±1.43d,P<0.05),手术时间长于对照组(162.33±19.57min vs 126.87±23.15min,P<0.05)。80例患者术后均获随访,随访时间15~40个月(19.0±6.3个月)。观察组患者术后1周、术后1个月的VAS评分分别为2.46±0.51分、1.21±0.38分,ODI分别为(17.84±4.15)%、(10.69±1.88)%,均低于对照组[VAS评分分别为3.68±0.62分、2.01±0.41分,ODI分别为(21.33±3.48)%、(12.33±2.17)%,均P<0.05],两组患者术后3个月、术后6个月的VAS评分比较无统计学差异(P>0.05)。观察组治疗优良率为92.11%,与对照组的85.71%比较无统计学意义(P=0.487)。两组患者融合分级比较,差异无统计学意义(Z=0.487,P=0.624)。观察组术后并发症发生率为5.26%,与对照组的9.52%比较无统计学差异(P=0.678)。结论:Delta大通道内镜辅助下后路椎管减压椎间植骨融合术治疗退变性腰椎疾病效果良好,可以减少术中出血量,缩短手术切口和住院时间,更快改善患者术后短期内疼痛、腰椎功能,安全性较好。展开更多
目的:比较前路与后路手术治疗胸腰椎结核的临床效果。方法:收集2021年1月至2023年6月在我院收住接受前路和后路治疗的40例胸腰椎感染性疾病患者的临床资料进行回顾性研究。根据两种术式不同,将患者分为两组。两组分别为前路组(n = 20)...目的:比较前路与后路手术治疗胸腰椎结核的临床效果。方法:收集2021年1月至2023年6月在我院收住接受前路和后路治疗的40例胸腰椎感染性疾病患者的临床资料进行回顾性研究。根据两种术式不同,将患者分为两组。两组分别为前路组(n = 20)和后路组(n = 20)。前路组和后路组疗效的影响进行统计分析,两组一般资料包括:患者性别、年龄、身体质量指数、受累节段、吸烟史及既往史等。结果:术前资料:两组患者年龄,性别,身体质量指数,受累节段,既往史(心脑血管疾病、呼吸系统疾病、内分泌系统疾病、代谢性疾病及结核病史),吸烟史,饮酒史,腰部VAS评分,腰部ODI评分及JOA评分等指标均无统计学差异(P > 0.05)。两组患者术后1月和末次随访腰部VAS评分相比差异均无显著性意义(P > 0.05);两组患者术后3月腰部VAS评分相比差异有显著性意义(P 0.05)。两组患者术后发生硬脊膜撕裂、下肢肌间静脉血栓、下肢深静脉血栓、切口感染、窦道形成及术后复发率相比差异均无显著性意义(P > 0.05),上述数据结果提示两种手术安全性方面无差异。前路组手术时间为121.50 ± 54.63,后路组为111.75 ± 49.84,后路组手术时间明显少于前路组组,两组间差异有统计学意义(t = 0.590, P > 0.05);后路组术中出血量为197.50 ± 92.95,前路组为314.00 ± 131.76,后路组术中出血量明显少于前路组,两组间差异有统计学意义(t = 3.231, P 0.05)。结论:前路手术和后路手术在治疗脊柱感染性疾病时,均被视为有效的治疗方式选择。这两种手术方法各有其特点,但它们在安全性和疗效性上并无显著的差异。Objective: To compare the clinical effects of anterior and posterior surgery in the treatment of thoracolumbar tuberculosis. Methods: The clinical data of 40 patients receiving anterior and posterior treatment for thoracolumbar infectious disease from January 2021 to June 2023 were collected for retrospective study. Patients were divided into two groups according on the two different procedures. The two groups were anterior group (n = 20) and posterior group (n = 20). The effect of efficacy in the anterior and posterior groups was analyzed statistically. General data in the two groups included patient gender, age, body mass index, affected segments, smoking history and past history. Results: preoperative data: two groups of patient’s age, gender, body mass index, affected segments, past history (cardiovascular and cerebrovascular disease, respiratory diseases, endocrine system disease, metabolic disease and tuberculosis history), smoking history, drinking history, waist VAS score, waist ODI score and JOA score are no statistical difference (P > 0.05). No difference in lumbar VAS scores between 1 month and last follow-up (P > 0.05);the difference between lumbar VAS scores was significant (P 0.05). There were no significant differences in dural tear, intermuscular venous thrombosis, deep vein thrombosis, incision infection, sinus formation and postoperative recurrence rate (P > 0.05). The above data suggest no difference in the safety of the two procedures. The operation time was 121.50 ± 54.63, 111.75 ± 49.84, posterior and less (t = 0.590, P > 0.05);197.50 ± 92.95, and 314.00 ± 131.76 in the anterior group (t = 3.231, P 0.05). Conclusion: Both anterior surgery and posterior surgery are considered as effective treatment options in the treatment of spinal infections. These two surgical methods each have their own characteristics, but there is no significant difference in their safety and efficacy.展开更多
文摘目的:探讨Delta大通道内镜辅助下后路椎管减压椎间植骨融合术治疗退变性腰椎疾病的效果。方法:回顾性分析2021年9月~2022年9月我院收治的80例退变性腰椎疾病患者的病历资料,根据患者治疗方式分为观察组(38例,男17例,女21例,年龄61.0±4.9岁)和对照组(42例,男20例,女22例,年龄60.5±5.4岁),观察组患者采取Delta大通道内镜下Endo-PLIF治疗,对照组采取开放后路腰椎椎间融合术治疗,记录两组患者术中出血量、术后引流量、手术时间、手术切口长度、住院时间,比较患者并发症发生情况。于术前、术后1周、1个月、3个月、6个月使用视觉模拟量表(visual analogue scale,VAS)评分评估患者腰痛情况,并采用Oswestry功能障碍指数(Oswestry disability index,ODI)评估患者腰椎功能;使用改良Macnab标准对患者进行疗效评估。根据患者术后1年随访时的腰椎影像学复查结果,使用Bridwell椎间融合标准对患者手术节段融合情况进行评估。结果:观察组患者的术中出血量及术后引流量分别低于对照组(88.46±10.98mL vs 112.99±12.01mL、159.73±18.42mL vs 201.36±23.06mL,P<0.05),手术切口及住院时间分别短于对照组(1.54±0.36cm vs 5.43±1.01cm、6.79±1.22d vs 8.03±1.43d,P<0.05),手术时间长于对照组(162.33±19.57min vs 126.87±23.15min,P<0.05)。80例患者术后均获随访,随访时间15~40个月(19.0±6.3个月)。观察组患者术后1周、术后1个月的VAS评分分别为2.46±0.51分、1.21±0.38分,ODI分别为(17.84±4.15)%、(10.69±1.88)%,均低于对照组[VAS评分分别为3.68±0.62分、2.01±0.41分,ODI分别为(21.33±3.48)%、(12.33±2.17)%,均P<0.05],两组患者术后3个月、术后6个月的VAS评分比较无统计学差异(P>0.05)。观察组治疗优良率为92.11%,与对照组的85.71%比较无统计学意义(P=0.487)。两组患者融合分级比较,差异无统计学意义(Z=0.487,P=0.624)。观察组术后并发症发生率为5.26%,与对照组的9.52%比较无统计学差异(P=0.678)。结论:Delta大通道内镜辅助下后路椎管减压椎间植骨融合术治疗退变性腰椎疾病效果良好,可以减少术中出血量,缩短手术切口和住院时间,更快改善患者术后短期内疼痛、腰椎功能,安全性较好。
文摘目的:比较前路与后路手术治疗胸腰椎结核的临床效果。方法:收集2021年1月至2023年6月在我院收住接受前路和后路治疗的40例胸腰椎感染性疾病患者的临床资料进行回顾性研究。根据两种术式不同,将患者分为两组。两组分别为前路组(n = 20)和后路组(n = 20)。前路组和后路组疗效的影响进行统计分析,两组一般资料包括:患者性别、年龄、身体质量指数、受累节段、吸烟史及既往史等。结果:术前资料:两组患者年龄,性别,身体质量指数,受累节段,既往史(心脑血管疾病、呼吸系统疾病、内分泌系统疾病、代谢性疾病及结核病史),吸烟史,饮酒史,腰部VAS评分,腰部ODI评分及JOA评分等指标均无统计学差异(P > 0.05)。两组患者术后1月和末次随访腰部VAS评分相比差异均无显著性意义(P > 0.05);两组患者术后3月腰部VAS评分相比差异有显著性意义(P 0.05)。两组患者术后发生硬脊膜撕裂、下肢肌间静脉血栓、下肢深静脉血栓、切口感染、窦道形成及术后复发率相比差异均无显著性意义(P > 0.05),上述数据结果提示两种手术安全性方面无差异。前路组手术时间为121.50 ± 54.63,后路组为111.75 ± 49.84,后路组手术时间明显少于前路组组,两组间差异有统计学意义(t = 0.590, P > 0.05);后路组术中出血量为197.50 ± 92.95,前路组为314.00 ± 131.76,后路组术中出血量明显少于前路组,两组间差异有统计学意义(t = 3.231, P 0.05)。结论:前路手术和后路手术在治疗脊柱感染性疾病时,均被视为有效的治疗方式选择。这两种手术方法各有其特点,但它们在安全性和疗效性上并无显著的差异。Objective: To compare the clinical effects of anterior and posterior surgery in the treatment of thoracolumbar tuberculosis. Methods: The clinical data of 40 patients receiving anterior and posterior treatment for thoracolumbar infectious disease from January 2021 to June 2023 were collected for retrospective study. Patients were divided into two groups according on the two different procedures. The two groups were anterior group (n = 20) and posterior group (n = 20). The effect of efficacy in the anterior and posterior groups was analyzed statistically. General data in the two groups included patient gender, age, body mass index, affected segments, smoking history and past history. Results: preoperative data: two groups of patient’s age, gender, body mass index, affected segments, past history (cardiovascular and cerebrovascular disease, respiratory diseases, endocrine system disease, metabolic disease and tuberculosis history), smoking history, drinking history, waist VAS score, waist ODI score and JOA score are no statistical difference (P > 0.05). No difference in lumbar VAS scores between 1 month and last follow-up (P > 0.05);the difference between lumbar VAS scores was significant (P 0.05). There were no significant differences in dural tear, intermuscular venous thrombosis, deep vein thrombosis, incision infection, sinus formation and postoperative recurrence rate (P > 0.05). The above data suggest no difference in the safety of the two procedures. The operation time was 121.50 ± 54.63, 111.75 ± 49.84, posterior and less (t = 0.590, P > 0.05);197.50 ± 92.95, and 314.00 ± 131.76 in the anterior group (t = 3.231, P 0.05). Conclusion: Both anterior surgery and posterior surgery are considered as effective treatment options in the treatment of spinal infections. These two surgical methods each have their own characteristics, but there is no significant difference in their safety and efficacy.
