| 椎间孔镜靶向单通道治疗青年腰椎融合术后相邻节段退变 |
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Received:January 16, 2021
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| 期刊信息：《中国骨伤》2021年34卷，第11期，第1001-1005页 |
| DOI：10.12200/j.issn.1003-0034.2021.11.003 |
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目的：比较椎间孔镜靶向单通道髓核摘除术（targeted one-channel percutaneous transforaminal endoscopic discectomy，TO-PTED）和腰椎间孔椎间融合术（transforaminal lumbar interbody fusion，TLIF）治疗青年腰椎融合术后相邻节段退变的临床疗效。
方法：对2017年9月至2019年2月收治的64例青年腰椎融合术后相邻节段退变患者进行回顾性分析。其中30例采用TO-PTED治疗（TO-PTED组），男19例，女11例；年龄23~34（31.20±1.67）岁；病程10~39（26.30±0.41）个月。34例采用TLIF治疗（TLIF组），男21例，女13例；年龄22~34（32.10±1.74）岁；病程11~40（27.10±0.32）个月。比较两组患者的手术时间、术中出血量、住院时间、X线透视次数；术前、术后1个月、末次随访采用视觉模拟评分（visual analogue scale，VAS）和日本骨科协会（Japanese Orthopaedic Association，JOA）评分对临床疗效进行评估。
结果：手术时间、术中出血量、住院时间、X线透视次数TO-PTED组分别为（76.30±5.08）min、（38.80±4.21）ml、（3.90±1.13）d、（8.80±2.53）次，TLIF组分别为（118.50±11.06）min、（162.71±19.31）ml、（7.30±1.42）d、（4.10±0.82）次，两组比较差异有统计学意义。所有患者获得随访，时间12~24（18.00±5.63）个月，在术后1个月及末次随访两组患者的VAS和JOA评分较术前均有明显改善，TO-PTED组优于TLIF组。
结论：TO-PTED和TLIF治疗青年腰椎融合术后相邻节段退变均能获得良好的疗效，TO-PTED在减少手术时间、术中出血量和术后恢复时间方面更有优势，但手术期间会增加患者接受术中辐射的次数 |
| [关键词]:外科手术,内窥镜 脊柱融合术 手术后并发症 相邻节段退变 |
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| Targeted one-channel percutaneous transforaminal endoscopic discectomy for the treatment of adjacent segment degeneration after spinal fusion surgery in young patients |
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Abstract:
Objective: To compare clinical efficacy between targeted one-channel percutaneous transforaminal endoscopic discectomy(TO-PTED) and transforaminal lumbar interbody fusion (TLIF) in treatment of adjacent segment degeneration (ASD) after spinal fusion surgery in young patients.
Methods: The clinical data of 64 patients with adjacent segment degeneration after spinal fusion fusion surgery from September 2017 to February 2019 were retrospectively analyzed. Among them, 30 patients were treated with TO-PTED (TO-PTED group), there were 19 males and 11 females, aged from 23 to 34 years, with a mean of(31.20±1.67) years;the course of disease was from 10 to 39 months, with a mean of (26.30±0.41) months. And other 34 patients were treated with TILF(TILF group), there were 21 males and 13 females, aged from 22 to 34 years, with a mean of(31.10±1.74) years;the course of disease was from 11 to 40 months, with a mean of (27.10±0.32) months. The operation time, intraoperative blood loss, hospitalization time, X-ray fluoroscopy times were compared between two groups. Visual analogue scale(VAS) and Japanese Orthopaedic Association(JOA) scores were used to evaluate the clinical efficacy between two groups before operation, 1 month after operation and at the final follow-up.
Results: Operation time, intraoperative blood loss, hospitalization time, X-ray fluoroscopy times were (76.30±5.08) min, (38.80±4.21) ml, (3.90±1.13) d, (8.80±2.53) times in TO-PTED group, and (118.50±11.06) min, (162.71±19.31)ml, (7.30±1.42)d, (4.10±0.82) times in TLIF group, respectively, the difference between the two groups was statistically significant. All patients were followed up from 12 to 24 months, with a mean of (18.00±5.63) months. VAS and JOA scores at 1 month after surgery and at final follow-up were obviously improved, and TO-PTED group was superior than TLIF group.
Conclusion: Both TO-PTED and TLIF can achieve good results in the treatment of adjacent segment degeneration after spinal fusion surgery in young patients. TO-PTED has advantages in reducing operation time, intraoperative blood loss and postoperative recovery time, but it will increase the number of patients receiving intraoperative radiation. |
| KEYWORDS:Surgical procedures,endoscopic Spinal fusion Postoperative complication Adjacent segment degeneration 3b |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 周亚旗,王肖虎,李智伟,杨杰,张新安,申明奎.椎间孔镜靶向单通道治疗青年腰椎融合术后相邻节段退变[J].中国骨伤,2021,34(11):1001~1005 |
| 英文格式: | ZHOU Ya-qi,WANG Xiao-hu,LI Zhi-wei,YANG Jie,ZHANG Xin-an,SHEN Ming-kui.Targeted one-channel percutaneous transforaminal endoscopic discectomy for the treatment of adjacent segment degeneration after spinal fusion surgery in young patients[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(11):1001~1005 |
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