小切口TLIF结合半坚强内固定系统治疗腰椎椎间盘退行性疾病

摘要

Objective To explore clinical efficacy of lumbar degenerative disc disease in the treatment of the small incision of TLIF technique combined with semi-rigid internal fixation system.Methods From March 2010 to March 2011,21 patients who underwent a single-level transfoaminal lumbar interbody fusion with semi-rigid internal fixation system for the treatment of lumbar degenerative disc disease were studied.All patients were received a posterior midline incision,muscle space approach,BIOFIX internal fixation,single cage implanted.Outcome measures included the VAS,Oswestry disability index (ODI) as well as a radiographic assessment of fusion.Results All patients were followed for 12-28 months (the mean time of 15.6 months).The postoperative difference of mean improvements in the ODI scores and VAS were statistically significant compared with the preoperative (P ＜ 0.05).Fusion rate was 100％.Conclusion The posterior small incision TLIF technology combined with semi-rigid internal fixation system in the treatment of lumbar degenerative disc disease is a safe and effective method.It can provide a stable mechanical environment to ensure interbody fusion,reduce the patient's surgical trauma,avoid adjacent disc degeneration caused by the rigid internal fixation.%目的 探讨小切口TLIF技术结合半坚强内固定系统治疗腰椎椎间盘退行性疾病的临床疗效.方法 2010年3月～2011年3月对21例腰椎椎间盘退行性疾病患者行后路小切口TLIF结合半坚强内固定系统,全部患者使用后正中切口,经肌间隙入路显露、单侧单节段BIOFIX内固定、单枚椎间CAGE (peek材料)植入,行椎管减压、椎间融合治疗腰椎椎间盘退行性疾病.记录视觉模拟评分(VAS)、Oswestry功能障碍指数(Oswestrydisability index,ODI)及融合情况.结果 21例患者均获随访,随访时间为12～28个月,平均随访15.6个月.术后即时及末次随访时VAS及ODI评分明显改善,与术前相比差异有统计学意义(P＜0.05),融合率为100％.结论 使用后路小切口TLIF技术结合半坚强内固定系统治疗腰椎椎间盘退行性疾病是一种安全、有效的方法,它能够在提供稳定的力学环境保证椎间融合的同时,减少患者的手术创伤,促进康复,并可能避免刚性内固定引起的邻近椎间盘退变.