管状通道下单侧入路双侧减压微创经椎间孔入路腰椎椎间融合术治疗单节段腰椎退行性疾病

目的 探讨管状通道下单侧入路双侧减压微创经椎间孔入路腰椎椎间融合术(MIS-TLIF)治疗单节段腰椎退行性疾病的临床疗效.方法 2013年11月—2016年2月,同济大学附属同济医院采用管状通道下单侧入路双侧减压MIS-TLIF治疗28例单节段腰椎退行性疾病患者.记录手术时间、术中出血量、术后引流量;测量手术前后及末次...

Bilateral decompression via single incision with tubular channel in minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative diseases

Objective To investigate the clinical effect of bilateral decompression via single incision with tubular channel in minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)for lumbar degenerative diseases.MethodsFrom November 2013 to February 2016,28 patients with single level lumbar degenerative disease were treated by MIS-TLIF(bilateral decompression via single incision with tubular channel)in Tongji Hospital Affiliated to Tongji University.The operation time,intraoperative blood loss and postoperative drainage volume were recorded.At pre-operation,post-operation and the final follow-up,the intervertebral space height and lumbar lordosis angle were measured;the low back and leg pain was evaluated by visual analogue scale(VAS)score;the lumbar function was evaluated by Oswestry disability index(ODI).At the final follow-up,the fusion was evaluated by Bridwell criteria and the clinical effect by MacNab criteria.Results All the operations were successfully completed.All the patients were followed up for 17-36 months.At the final follow-up,the intervertebral space height increased from(0.98±0.23)cm to(1.22±0.18)cm,the lumbar lordosis angle increased from 31.08°±12.63°to 33.81°±11.27°,the VAS score of low back pain decreased from 5.96±0.84 to 1.61±0.50,the VAS score of leg pain decreased from 6.46±0.74 to 1.57±0.57,and ODI decreased from(59.75±4.83)%to(16.64±2.09)%,and the differences were statistically significant(P<0.05).At the final follow-up,26 cases(92.9%)had gradesⅠandⅡfusion.The clinical effect was excellent in 18 cases,good in 8 and fair in 2.Conclusion Bilateral decompression via single incision with tubular channel in MIS-TLIF is effective in the treatment of unilateral nerve root symptoms with central spinal stenosis and unilateral nerve root symptoms with gradeⅠlumbar spondylolisthesis.