内镜下经椎间孔腰椎椎体间融合术治疗退变性腰椎滑脱症.doc

1 内镜下经椎间孔腰椎椎体间融合术治疗退变性腰椎滑脱症【摘要】探讨内镜下经椎间孔入路腰椎椎体间融合术治疗退变性腰椎滑脱症的疗效。[ 方法] 2005 年1 月~ 200 5 年 12月, 在内镜辅助下经椎间孔入路行腰椎体间植骨融合、椎弓根钉复位内固定术治疗单节段退变性腰椎滑脱症患者 17 例。男 10 例,女 7例; 年龄 35~ 68 岁,平均 岁。 L4 椎体滑脱 11 例, L5 椎体滑脱 6 例;根据 Meyerding 滑脱分类: Ⅰ度滑脱 10 例, Ⅱ度滑脱 7 例。伴有 L4 、5 椎间盘突出7 例、椎管狭窄 5 例, L5S1 椎间盘突出 4例。[结果] 17 例手术顺利, 手术时间平均 160 min ; 术中失血量平均 120 ml; 平均住院时间 8d ;无神经损伤, 无中转开放手术。围手术期发生椎间隙感染 1 例。 17 例病人获得随访,时间 12~ 24个月,平均 个月。融合率 100 %。 ODI 评分术前平均为 % , 术后 3 个月平均为 % , 术后 6 个月平均为 % , 优良率 %。[结论]内镜下经椎间孔入路腰椎椎体间融合术治疗退变性腰椎滑脱症, 手术切口短、创伤小、出血少, 术后功能恢复快,临床效果满意。 2 【关键词】显微内窥镜腰椎滑脱经椎间孔腰椎椎体间融合术 Abstract :[ Objective ] To investigate the effect of treating degenerative spondylolisthesis by transforaminal lumbar interbody fusion with microendoscopic surgery. [ Method ] From January 2005 to December 2005,17 cases who underwent transforaminal lumbar interbody fusion with a pedicle screw system by microendoscopic surgery were analyzed retrospectively. The index diagnosis was degenerative lumbar spondylolisthesis with herniated nucleus pulposus in 11 cases,and with spinal canal stenosis in5 were 10 male and 7 female,average age was (ranged,35 ~ 68) to Meyerding grading system,roentgengram showed that there were 10 cases of grade Ⅰ° ,7 cases of grade Ⅱ° ,11 cases of L4 and 6 L5. [ Result ] Seventeen cases were reviewed after postoperative follow 拟 up ranged from 12 months to 24 months(averaged months).Operative time averaged 160 blood loss averaged 120 length of hospital stay was 8 were no nerve injury occurred during cases converted to open ,one case suffered from intervertebral 3 were quantified using Oswestry Disability average Oswestry score decreased from % preoperatively to % at3 month and % at6 month rate of excellent and good was %.At last follow 拟 up,all patients had solid fusions by radiographic criteri