直视下微创腰椎融合术治疗腰椎退行性疾病的近期疗效观察

摘要

目的 探讨直视下微创腰椎融合术与传统开放式腰椎融合术治疗腰椎退行性疾病的近期临床效果及相关问题.方法 选择我院2010年8月至2011年1月行直视下微创腰椎融合术与传统开放式腰椎融合术治疗腰椎退行性疾病共60例进行回顾性分析,其中传统开放式30例,微创30例.分别记录两组患者的手术时间、术中出血量、术后下床活动时间、术后住院时间、术前与术后JOA评分,进行统计学分析.评估手术疗效及临床症状改善程度.结果 a)两组患者在年龄、性别、体重、临床症状和体征、病程、发病节段、病变类型方面经t检验及x2检验、在统计学上无显著差异(P＞0.05).b)微创组的术中出血量、术后下床时间、术后住院时间明显少于开放组,两组差异具有显著统计学意义(P＜0.01).c)两组术后3个月JOA评分的差异有统计学意义(P＜0.05).结论 直视下微创腰椎融合术治疗腰椎退行性疾病较传统开放式腰椎融合术具有术中出血少、创伤小、住院时间短、术后恢复快等优点.%Objective To evaluate the eary clinical effects and related problems of minimal invasive interbody fusion under direct vision and traditional open interbody fusion in the treatment of lumbar degenerative disease. Methods Retrospective analysis to 60 patients in the group, in which all were treated with minimally interbody fusion by direct vision and traditional open interbody fusion. From August 2010 to January 2011,60 cases were collected in our hospital,including 30 cases in open group and 30 cases in minimal invasive group. The bleeding volume in operation and operation time,time of activities and hospitalization after operation,preoperative and postoperative JOA score were recorded for statistical analysis.Results a)The patients of two groups had no differences on age,weight,gen-der,clinical manifestations,signs,course,segment diseuse and lesion type(P>0. 05). b)The bleeding volume in operation, actived time and hospitalization after operation of the minimal invasive group were significantly less than the open group. The two groups had statistic significance (P<0. 01). c)There were statistic differences (P<0.05) in JOA score 3 month after operation between the two groups. Conclusion The minimal invasive interbody fusion by direct vision has much advantage over the traditional open interbody fusion,with less blood lossless trauma,shorter hospitalization and a more rapid postoperative recovery.