经 Quadrant通道椎弓根螺钉内固定与传统后路椎弓根内固定治疗腰椎退行性疾病的比较研究

摘要

Objective To evaluate the effects of Quadrant minimally invasive treatment system versus traditional technique plus posterior approach applied to pedicle screw fixation on the treatment of lumbar degenerative disease . Methods The data of 126 patients suffered from lumbar degenerative disease were analyzed retrospectively .According to the operation method,126 cases were divided into two groups:62 in the minimally invasive group who were treated with Quadrant minimally invasive treatment system,64 in the open group who were treated with traditional operation.The operation status,the improvement of symptoms and radiography results of two groups were compared .Results The patients of two groups all achieved the remarkable curative effects after surgery .The improvement rate of quality of life of minimally invasive group was better than that of open group at discharge (P<0.05).But there was no significant difference in the improvement rate of quality of life at one month after operation or in the last follow-up between two groups (P>0.05).The surgical incision length,intraoperative blood loss,postoperative drainage flow,ambulation time,postoperative hospitalization time of Quadrant group were significantly less than those of open group (P<0.05).The excellent rate of JOA score showed no significant difference between two groups in the last follow-up(P>0.05).Conclusion Quadrant minimally invasive system applied to treating lumbar degenerative disease has the advantages of less tissue damage ,less bleeding and quicker postoperative recovery .The operation is simple and the clinical effect is definite .It is worthy of clinical application .%目的：比较经Quadrant通道椎弓根螺钉内固定与传统后路椎弓根固定治疗腰椎退行性疾病的疗效。方法回顾分析126例腰椎退行性疾病患者的临床资料，按手术方式分为两组，其中Quadrant微创组62例和传统开放组64例。对比分析两组患者手术情况、症状改善情况及影像学资料。结果两组患者术后均获得了显著的疗效，出院时微创组生活质量改善率优于开放组（P＜0．05），术后1个月及末次随访时微创组生活质量改善率与开放组比较，差异无统计学意义（P＞0．05），而微创组手术切口长度、术中出血量、术后引流量、术后下床活动时间、术后住院时间均明显短于开放组（P＜0．05），末次随访日本矫形外科协会（JOA）评分优良率比较，差异无统计学意义（ P＞0．05）。结论 Quadrant微创技术具有操作损伤少、手术出血少、术后恢复快等优点，且手术操作不复杂，临床疗效确切，其治疗价值得临床推广。