作者
黄海滨,李智斐,肖宇明
文章摘要
目的:比较单侧双通道内镜下腰椎融合术(unilateral biportal endoscopic lumbar interbody fusion,ULIF)与微创经椎间孔入路腰椎融合术(minimally invasive transforaminal lumbar interbody fusion,MIS-TLIF)在单节段腰椎退变性疾病(lumbar degenerative disease,LDD)中的应用与疗效。方法:回顾分析兴安界首骨伤医院2022年1月至2023年12月56例腰椎退行性疾病患者56例,采用ULIF治疗28例(ULIF组),MIS-TLIF治疗28例(MIS-TLIF组),对两组手术的时间、手术中的出血量、手术后的引流量、住院天数、C反应蛋白(CRP)、术后第1天肌酸激酶水平、疼痛视觉模拟(visual analog scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、改良MacNab评分、并发症发生率等指标进行对比。结果:ULIF组平均手术时间较长,肌酸激酶较高,均有显著差异(P<0.05);手术中的出血量、术后引流量以及住院时间较MIS-TLIF组少,术后早期疼痛感较MIS-TLIF组低。术后CRP水平差异无统计学意义(P>0.05)。在6个月的随访中,两组患者改良MacNab评分优良率无统计学差异;两组患者并发症发病率无统计学差异。结论:ULIF对单节段腰椎退变性病变的疗效明显,较MIS-TLIF可显著减少手术当中的出血量,明显减少术后恢复时间,改善患者腰腿痛的临床症状,提高腰腿痛患者的生活质量,临床上有一定应用价值。
文章关键词
单侧双通道内镜;微创;腰椎融合;脊柱外科;腰椎退行性疾病
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