极外侧入路椎间融合术在腰椎退行性疾病中的应用效果

Effect of extralateral approach interbody fusion in lumbar degenerative diseases

  • 摘要:
      目的  分析极外侧入路椎间融合术在腰椎退行性疾病中的应用效果。
      方法  选择本院收治的50例腰椎退行性疾病患者,全部患者选择极外侧入路椎间融合术治疗,观察分析治疗效果。
      结果  全部患者顺利完成手术,平均术中出血量为(145.5±4.7) mL, 平均手术时间为(56.3±2.2) min, 平均住院时间为(7.2±1.5) d。术后4例患者出现屈髋乏力, 2个月后症状彻底恢复。6例患者术后出现大腿前方感觉麻木感,6~8周后症状消失或者缓解。本研究患者无腹腔脏器和大血管损伤、脑脊液漏、椎间隙定位错误、麻痹性肠梗阻、生殖股神经永久性损伤等并发症。全部患者接受为期24个月的随访,结果发现末次随访时,患者的腰痛视觉模拟(VAS)评分、下肢痛VAS评分均显著低于术前(P < 0.05), 日本骨科协会腰椎(JOA)评分显著高于术前(P < 0.05)。
      结论  选择极外侧入路椎间融合术治疗腰椎退行性疾病患者能取得比较理想的效果,并发症少,椎间融合率高。

     

    Abstract:
      Objective  To analyze the effect of extralateral approach interbody fusion in the treatment of degenerative lumbar diseases.
      Methods  A total of 50 patients with lumbar degenerative diseases admitted to our hospital were selected, and were treated with extralateral approach interbody fusion, and the therapeutic effect was observed and analyzed.
      Results  All patients successfully completed the operation. The average amount of bleeding during operation was(145.5±4.7)mL, the average operation time was(56.3±2.2)min, and the average hospitalization time was(7.2±1.5) days. Four patients suffered from hip flexion weakness after operation, and the symptoms recovered completely after two months. Six patients suffered from sensory numbness in front of thighs after operation, and the symptoms disappeared or relieved after 6 to 8 weeks. No complications such as abdominal organs and blood vessels injury, cerebrospinal fluid leakage, mislocation of intervertebral space, paralytic intestinal obstruction and permanent injury of genitofemoral nerve occurred. All patients were followed up for 24 months. The results showed that at the last follow-up, the Visual Analogue Scale (VAS) scores of low back pain and lower limb pain were significantly lower, and the lumbar spine scores of Japanese Orthopaedic Association(JOA) were significantly higher than before operation (P < 0.05).
      Conclusion  Extralateral approach interbody fusion can achieve satisfactory results in the treatment of lumbar degenerative diseases, with fewer complications and higher fusion rate.

     

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