Objective To observe the short-term clinical efficacy of minimally invasive posterior lumbar interbody fusionC PLIF) using a single cage fixed with unilateral percutaneous pedicle screw in treating lumbar degenerative diseases. Methods A total of 55 patients with one level lumbar degenerative disease was treated with minimally invasive unilateral PLIF(group A, 21 cases) or with PLIF via conventional posterior median inlet and bilateral pedicle screw fixation(group B,34 cases). Incision size, operation time, blood loss and hospital stay were compared. The short-term clinical efficacy was evaluated with VAS and JOA scores one week and 3 months after surgery. Results All patients were followed up from 3 to 18 months. Compared to group B.the incision was smaller, blood loss was less and hospital stay was shorter in group A(P<0. 05). The VAS and JOA scores one week and 3 months after surgery were not significantly different between two groupsCP>0. 05). Conclusion Minimally invasive unilateral PLIF has the advantages of small incision, little bleeding, short hospital stay and better recovery.%目的 评价克氏针钻头法在胸椎椎弓根置钉技术中临床运用的准确性及安全性.方法 选择横突上嵴与上关节突基底中线的交点为进针点,2.5mm克氏针钻头缓慢旋转进入钉道直至深度为30 mm.椎弓根探子确认钉道5个壁后,直径3.5mm丝攻进行攻丝,再次探查骨道后,根据术前CT测量拧入相应规格的螺钉.25例患者共210枚螺钉纳入临床研究,螺钉位置根据术后CT扫描并按照Heary进行分级,评价其准确性及安全性.结果 采用克氏针钻头法置入胸椎椎弓根螺钉210枚,术中及术后未出现神经、血管及内脏损伤等并发症.术后CT扫描有18(8.57％)枚螺钉穿透骨皮质,4枚螺钉穿透椎弓根内侧壁＜2mm.按照Heary分级,其置钉准确性达98.09％(206/210).结论 克氏针钻头法在临床运用中能准确而安全地置入胸椎椎弓根螺钉,并能缩短手术时间、减少医患人员的放射线危害.
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