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1、内镜下经椎间孔腰椎椎体间融合术治疗退变性腰椎滑脱症【摘要】探讨内镜下经椎间孔入路腰椎椎体间融合术治疗退变性腰椎滑脱症的疗效。[方法]2005年1月~2005年12月,在内镜辅助下经椎间孔入路行腰椎体间植骨融合.椎弓根钉复位内固定术治疗单节段退变性腰椎滑脱症患者17例。男10例,女7例;年龄35-68岁,平均47.6岁丄4椎体滑脱11例,L5椎体滑脱6例;根据Meyerding滑脱分类:T度滑脱10例,H度滑脱7例。伴有L4,5椎间盘突出7例、椎管狭窄5例,L5S1椎间盘突出4例。[结果]17例手术顺
2、利,手术时间平均160min;术中失血量平均120ml;平均住院时间8d;无神经损伤,无中转开放手术。围手术期发生椎间隙感染1例。17例病人获得随访,时间12-24个月,平均16.2个月。融合率100%。ODT评分术前平均为48.3%,术后3个月平均为16.5%,术后6个月平均为14.0%,优良率97.5%。[结论]内镜下经椎间孔入路腰椎椎体间融合术治疗退变性腰椎滑脱症,手术切口短、创伤小、出血少,术后功能恢复快,临床效果满意。【关键词】显微内窥镜腰椎滑脱经椎间孔腰椎椎体间融合术Abstract:[
3、Objective]Toinvestigatetheeffectoftreatingdegenerativespondylolisthesisbytransforamina1lumbarinterbodyfusionwithmicroendoscopicsurgery.[Method]FromJanuary2005toDecember2005,17caseswhounderwenttransforaminallumbarinterbodyfusionwithapediclescrewsystemby
4、microendoscopicsurgerywereanalyzedretrospectively.Theindexdiagnosiswasdegenerativelumbarspondylolisthesiswithherniatednucleuspulposusin11cases,andwithspinalcanalstenosisin5cases.Therewere10maleand7female,averageagewas47.6(ranged,35~68)years.Accordingto
5、Meyerdinggradingsystem,roentgengramshowedthattherewere10casesofgradeI°,7casesofgradeII°,11casesofL4and6L5・[Result]Seventeencaseswerereviewedaftersurgery.Thepostoperativefollowuprangedfrom12monthsto24months(averaged16.2months).0perativetimeaveraged160mi
6、nutes.Estimatedbloodlossaveraged120ml.Meanlengthofhospitalstaywas8days.Therewerenonerveinjuryoccurredduringoperation.Nocasesconvertedtoopenoperation.Incomplications,onecasesufferedfromintervertebralinfection.OutcomeswerequantifiedusingOswestryDisabi1it
7、yTndex.TheaverageOswestryscoredecreasedfrom48.3%preoperativelyto16.5%at3monthand14.0%at6monthpostoperative!y.Therateofexcellentandgoodwas97.5%.Atlastfollowup,al1patientshadsolidfusionsbyradiographiccriteria.[Cone1usion]Transforaminallumbarinterbodyfusi
8、onforlumbarvertebraldegenerativespondylolisthesisbymicroendoscopicsurgeryhastheadvantagesofshorterskinincision,lesstissuedamage,lessbloodlossandquickerpostoperativerecovery.Keywords:microendoscopic;spondylolisthesis;transforaminallumbar