Viper联合Quadrant通道TLIF术治疗腰椎退变性疾病.doc

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1、Viper联合Quadrant通道TLIF术治疗腰椎退变性疾病魏康霍玉兴赵洪彭立波沈鹏飞(常州市中医医院骨一科江苏常州213100)【摘要】目的：探讨Quadrant通道下腰椎管减压、椎间融合、Viper经皮椎弓根钉固定治疗腰椎退变性疾病的临床效果。方法：2012年1月〜2014年1月收治腰椎退变性疾病患者46例，男27例，女19例；年龄49-81岁，平均65.1岁。均采用Quadrant通道下腰椎管减压、椎间融合、Viper经皮椎弓根内固定治疗，随访观察VAS评分、ODI指数、Macnab评级。结果：手术时间110〜225min,平均145.3min

2、；所有患者手术切口均一期愈合，术后平均住院时间8.5d(7〜12d)。所有患者最少随访12月。腰痛VAS术前评分(6.82±0.34)分，术后(3.11±0.73)分；腿痛VAS术前评分(8.03±0.59)分，术后(3.52±0.32)分；ODI术前指数(76.37±5.13),术后(32.58±3.43)e根据Macnab评级，优36例(78.2%),良10例(21.8%)。结论:Viper联合Quadrant通道TLIF术治疗腰椎退变性疾病具有损伤小、疗效好、恢复

3、快等优点。【关键词】微创；Viper经皮椎弓根固定；Quadrant通道；腰椎退行性疾病【中图分类号】R615【文献标识码】A【文章编号】1007-8231(2015)13-0113-03TheclinicaleffectoftransforaminallumbarinterbodyfusionviaQuadrantsystemcombinedwithViperinthetreatmentoflumbardegenerativediseasesWeiKang,QuYuxing,ZhaoHong,etal.DepartmentofOrthopedics,

4、ChangzhouTCMHospital,ChangzhouJiangsuChina,213100,China[Abstract]ObjectiveToevaluatetheclinicaleffectofsurgicaltreatmentwithspinalcanaldecompression,autograftandcageimplantationforinterbodyfusionusingQuadrantoperationsystem,andpercutaneouspediclescrewfixationusingViperoperations

5、ysteminpatientswithlumbardegenerativediseases.MethodsForty-sixpatientsweretreatedfromJan2012toJan2O14.Themeanagewas65.1years(49〜81yearsold).Postoperativeregularfollow-upincludinglumbocruralpainVASscore,ODIandMacnab.ResultsTheaverageoperationtimewas145.3min(rangeJIO〜215min).Theme

6、anVASscoreinlowbackpainJegpainandODIwasrespectively(6.82±0.34)(8.03±0.59)and(76.37±5.13)preoperativeywhile(3.11±0.73)(3.52±0.32)and(32.58±3.43)postoperativey.ConclusionIthasshownpredominantbenefits:lesstrauma,betterefficacyandrapidpostop

7、erativerecovery.【Keywords】Minimallyinvasion;Viperpercutaneouspediclescrewfixation;Quadrantsystem;Lumbardegenerativedisease目前经椎间孔椎体间融合(transforaminallumbarinterbodyfusion,TLIF)技术是治疗腰椎退行性疾病的常用术式，然而传统TLIF术存在手术切口大、软组织及椎旁肌剥离多等缺点，影响了手术效果，甚至引起术后患者长期的慢性腰痛。Viper经皮椎弓根钉固定及Quadrant通道下TLIF术采

8、用微创手术入路及手术操作,避免了传统TLIF手术中广泛剥离及过度牵拉椎旁肌，减少了损伤。自20