| 微创和开放手术治疗腰椎峡部裂滑脱的疗效分析 |
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| 引用本文： | 丁金勇,刘涛,周跃,钱莘.微创和开放手术治疗腰椎峡部裂滑脱的疗效分析[J].中国骨与关节损伤杂志,2009,24(8). |
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| 作者姓名： | 丁金勇 刘涛 周跃 钱莘 |
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| 作者单位： | 1. 第三军医大学附属新桥医院骨科,重庆市,400037
2. 武警广东总队医院肿瘤科 |
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| 摘 要： | 目的 比较微创和开放两种术式治疗腰椎峡部裂滑脱的临床效果.方法 采用改良内镜(METRx)减压联合经皮椎弓根螺钉固定(Sextant)微创治疗腰椎峡部裂滑脱25例,传统开放手术治疗31例.统计手术时间、术中失血量、平均住院日、术后镇痛药物使用情况;用VAS评分评估患者术前、术后疼痛缓解情况;采用改良Macnab标准评估临床疗效;影像学观察比较术前、术后椎体滑脱距离、椎间盘高度、滑脱角改善情况及椎问融合率.结果 患者平均随访2.8年(2～4.5年),5例失访.微创组术中失血量、平均住院时间较开放组明显减少;手术时间较开放组长,但无显著性差异.最终随访的VAS评分方面.微创组和开放组均较术前明显降低.具有显著性差异;两组病例在MacNab 临床疗效评价结果 及椎间融合率方面相似,没有显著性差异;两组病例腰椎滑脱距离、椎间盘高度及滑脱角均较术前改善,并有统计学意义,但开放组和微创组比较,无统计学意义.结论 微创手术具有创伤小、术中出血少、术后疼痛轻、平均住院时间短、术后恢复快等特点.而椎问融合率及临床腰部功能评价与开放手术疗效相似,是治疗腰椎峡部裂滑脱的一种有效方法.
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| 关 键 词： | 腰椎峡部裂滑脱 微创手术 椎弓根螺钉固定 椎间融合 |
Comparison between Minimally Invasive Spine Surgery and Open Surgery in Isthmic Spondylolisthesis |
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| Ding Jinyong,Liu Tao,Zhou Yue,et al..Comparison between Minimally Invasive Spine Surgery and Open Surgery in Isthmic Spondylolisthesis[J].Chinese Journal of Bone and Joint Injury,2009,24(8). |
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| Authors: | Ding Jinyong Liu Tao Zhou Yue |
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| Institution: | Ding Jinyong,Liu Tao,Zhou Yue,et al.Department of Orthopaedics,XinQiao Hospital of Third Military Medical University,Chongqing,400037 |
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| Abstract: | Objective To assess the difference in clinical efficacy on surgical treatment of isthmic spondylolisthesis between minimally invasive spine surgery(MISS) and open surgery by the postoperative and long term follow-up results.Methods Twenty-five patients of total 56 were subjected to posterior lumbar interbody fusion(PLIF) with pedicle screws supported by MISS(METRx plus Sextant techniques) and the rest with PLIF and pedicle screws.The initial postoperative,long-term clinical,functional and radiographic outco... |
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| Keywords: | Lumbar isthmic spondylolysis Minimally invasive spine surgery Pedicle screw fixation Posterior lumbar interbody fusion |
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