计算机导航微创经椎间孔腰椎椎间融合治疗腰椎滑脱

背景:目前已有研究报道计算机导航引导下脊柱手术与传统手术相比具有可视化、精准化等特点,此次试验进一步探索研究.目的:对比计算机辅助导航联合锥形通道椎间盘镜下微创经椎间孔腰椎椎间融合与传统开放手术治疗腰椎滑脱的临床疗效,为临床选择治疗方案提供依据.方法:回顾分析2014年3月至2018年3月曲靖市第一人民医院脊柱外科完成...

Computer-assisted navigation combined with minimally invasive transforaminal lumbar interbody fusion for lumbar spondylolisthesis

BACKGROUND:At present,some studies have reported that navigation assisted spinal surgery has the characteristics of visualization and precision compared with traditional surgery,and this tail will further explore and study it.OBJECTIVE:To compare the clinic effect between minimally invasive transforaminal lumbar interbody fusion with computer navigation and open transforaminal lumbar interbody fusion in the treatment of lumbar spondylolisthesis and provide evidence to choose a batter operative method.METHODS:A retrospective analysis of 60 patients with lumbar spondylolisthesis who were hospitalized at the Department of Spine Surgery,No.1 People’s Hospital of Qujing from March 2014 to March 2018 undergoing transforaminal lumbar interbody fusion was conducted.Of them,30 cases were treated with navigation and microendoscopic discectomy(minimally invasive group);other 30 cases underwent open-transforaminal lumbar interbody fusion and pedicle screw fixation(open group).Operation time,blood loss,postoperative drainage volume,postoperative bedridden time,hospitalization time,and complications were collected in both groups.Visual analogue scale scores and Oswestry disability index were followed up.Accuracy of pedicle screw insertion and bone graft fusion rate were assessed using imaging examination between the two groups.Above indexes were statistically analyzed and compared between the two groups.RESULTS AND CONCLUSION:(1)All patients were followed up from 12 to 40 months.(2)There were no significant differences between two groups in age,sex,preoperative visual analogue scale,Oswestry disability index,and level of spondylolysis(P>0.05).(3)The operation time was slightly longer in the minimally invasive group than in the open group,but there was no significant difference in operation time between the two groups(P>0.05).The blood loss,the postoperative drainage volume,bedridden time and hospitalization time of minimally invasive group were significantly less than those of open group(P<0.05).(4)Oswestry disability index and back pain visual analogue scale scores were significantly decreased after treatment in both groups;moreover,visual analogue scale scores and Oswestry disability index of minimally invasive group were lower than that of open group after operation(P<0.05).(5)The accuracy of pedicle screw insertion of minimally invasive group was superior to that of open group(P<0.05).(6)No obvious internal fixation loosening,broken,or abnormal activities were found in all patients during the follow-up.There was no significant difference in the bone graft fusion rate between the two groups at the last follow-up.(7)It is indicated that compared with the open transforaminal lumbar interbody fusion,computer-assisted navigation combined with microendoscopic discectomy channel minimally invasive transforaminal lumbar interbody fusion treatment for lumbar spondylolisthesis has advantages of less blood loss,less trauma,less bedridden time,rapid recovery,higher accuracy of pedicle screw insertion,which is a good selection for lumbar fusion.