| MAST Quadrant通道下椎旁肌间隙入路单边固定椎间融合治疗退变性腰椎不稳症 |
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投稿时间：2015-05-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 何升华 |
HE Sheng-hua |
深圳市中医院, 广东 深圳 518033 |
Shenzhen Hospital of TCM, Shenzhen 518033, Guangdong, China |
heshenghua99@163.com |
| 马笃军 |
MA Du-jun |
深圳市中医院, 广东 深圳 518033 |
Shenzhen Hospital of TCM, Shenzhen 518033, Guangdong, China |
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| 赵祥 |
ZHAO Xiang |
芜湖市中医医院, 安徽 芜湖 241000 |
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| 丁浩 |
DING Hao |
芜湖市中医医院, 安徽 芜湖 241000 |
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| 方俊 |
FANG Jun |
芜湖市中医医院, 安徽 芜湖 241000 |
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| 期刊信息：《中国骨伤》2016年，第29卷，第5期，第424-428页 |
| DOI：10.3969/j.issn.1003-0034.2016.05.007 |
| 基金项目: |
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| 中文摘要:目的:观察MAST Quadrant通道辅助下经椎旁肌间隙入路行单侧椎弓根钉棒固定及单枚cage椎间融合术式治疗腰椎退变性不稳症的临床疗效,探讨该术式的优势。方法:回顾性分析2010年2月至2011年12月资料完整并得到随访经保守治疗无效的退变性腰椎不稳症患者39例,全部采用MAST Quadrant通道辅助下经椎旁肌间隙入路行单边钉棒固定椎间融合治疗,记录患者手术时间、出血量和并发症,在术前、术后1个月及末次随访时进行VAS疼痛评分和下腰痛JOA(包括腰痛主观症状、下肢痛及麻木、感觉障碍和运动障碍)评分以及改良Macnab疗效评定,末次随访拍摄X线片观察椎间融合情况。结果:39例均获随访,随访时间(22.3±8.6)个月,手术时间(138±46) min,出血量(335±152) ml,术中未发生脑脊液漏、脊神经损伤,术后无切口感染。VAS评分由术前7.93±1.27降低到术后1个月2.05±1.18及末次随访1.89±0.42;JOA总评分由术前1.59±0.42提高到术后1个月8.86±0.37及末次随访9.02±0.29.按照改良Macnab标准,优17例,良19例,可3例。末次随访35例椎体间明显骨性融合。结论:MAST Quadrant通道下经椎旁肌间隙入路行单侧椎弓根钉棒固定及单枚cage椎间融合治疗退变性腰椎不稳症,具有安全性好、创伤小、出血少、疗效满意等优点。 |
| 【关键词】关节不稳定 腰椎 内固定器 外科手术 |
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| Unilateral fixation combined with interbody fusion for the treatment of lumbar degenerative instability via a paraspinal intermuscular approach under MAST Quadrant retractor |
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| ABSTRACT Objective: To study clinical effects of unilateral pedicle screw-rod system fixation combined with the single the cage of interbody fusion in the treatment of lumbar degenerative instability via paraspinal intermuscular approach under MAST Quadrant retractor. Methods: From February 2010 to December 2011,39 patients with lumbar degenerative instability after invalid conservative treatment were treated with unilateral fixation combined with interbody fusion via the paraspinal intermuscular approach under MAST Quadrant retractor. The indexes such as the operative time,blood loss,complications,VAS pain scores,JOA (subjective symptoms of low back pain,lower limb pain and numbness,sensory disturbance,movement disorders) scores,modified Macnab criteria for curative effect evaluation were observed before treatment,at the 1st month after treatment and the latest follow-up. The intervertebral fusion was studied on the X-ray at the latest follow-up. Results: All the patients were followed up,and the mean during was(22.3±8.6) months. The operation time was(138±46) min,and the amount of bleeding was (335±152) ml. There were no complications such as cerebrospinal fluid leakage and spinal nerve injury during operation,and no incision infection after operation. The VAS pain score was reduced from preoperative 7.93±1.27 to 2.05±1.18 on the 1st month after operation and 1.89±0.42 at the latest follow-up. The JOA total score was improved from preoperative 1.59±0.42 to 8.86±0.37 on the 1st month and 9.02±0.29 at the latest follow-up. According to modified Macnab criteria,there were 17 cases got an excellent result,19 good,3 case fair. Thirty-five patients got intervertebral bony fusion at the latest follow-up. Conclusion: Unilateral pedicle screw-rod system fixation combined with single cage interbody fusion in the treatment of lumbar degenerative instability via paraspinal intermuscular approach under MAST Quadrant retractor is a safe,minimally invasive,satisfactorily effective methods to treat lumbar degenerative instability. |
| KEY WORDS Joint instability Lumbar vertebrae Internal fixator Surgical procedure,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 何升华,马笃军,赵祥,丁浩,方俊.MAST Quadrant通道下椎旁肌间隙入路单边固定椎间融合治疗退变性腰椎不稳症[J].中国骨伤,2016,29(5):424~428 |
| 英文格式: | HE Sheng-hua,MA Du-jun,ZHAO Xiang,DING Hao,FANG Jun.Unilateral fixation combined with interbody fusion for the treatment of lumbar degenerative instability via a paraspinal intermuscular approach under MAST Quadrant retractor[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(5):424~428 |
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