| 刘鏐,谷艳超,李莹.Delta椎板间内镜技术与开放经椎间孔入路椎间融合术治疗单节段腰椎失稳的对比研究.骨科,2022,13(2): 110-114. |
| Delta椎板间内镜技术与开放经椎间孔入路椎间融合术治疗单节段腰椎失稳的对比研究 |
| Comparative Study of iLESSYS Delta Endoscopic System and Open Transforaminal Lumbar Interbody Fusion in the Treatment of Single Segment Lumbar Instability |
| 投稿时间：2021-09-14 |
| DOI：10.3969/j.issn.1674-8573.2022.02.003 |
| 中文关键词: Delta大通道内镜系统 微创技术 经椎间孔入路腰椎椎体间融合术 |
| 英文关键词: iLESSYS-Delta System Minimally invasive technology Transforaminal lumbar interbody fusion |
| 基金项目:武汉市临床医学科研项目（WX20D19） |
|
| 摘要点击次数: 2240 |
| 全文下载次数: 2544 |
| 中文摘要: |
| 目的 对比Delta椎板间内镜技术（iLESSYS Delta）与开放经椎间孔入路腰椎椎体间融合术（transforaminal lumbar interbody fusion，TLIF）治疗单节段腰椎失稳的临床效果。方法 选取本院2018年3月至2021年3月需行手术治疗的单节段腰椎不稳病人80例，采取简单数字表随机分组法分为内镜组（40例）和开放组（40例）。记录两组的手术时间、切口长度、术中硬膜破裂数、术后血肿数、平均住院日。采用Oswestry功能障碍指数（Oswestry disability index，ODI）和疼痛视觉模拟量表（visual analogue scale，VAS）评估病人术前及术后1个月、3个月、末次随访时的功能及疼痛情况，并记录各时段的椎间隙高度、椎管面积、腰椎前凸角及末次随访时椎体融合情况。结果 所有病人均顺利完成手术。与开放组比较，内镜组的手术时间长、切口长度短、住院时间短，组间比较，差异有统计学意义（P＜0.05）。术中开放组发生1例（2.5%）硬膜破裂，术后对症处理后康复出院；两组术后均未出现血肿病例。病人术后随访（11.63±3.70）个月（6~18个月）。内镜组术后1、3个月的VAS评分显著优于开放组，差异有统计学意义（P＜0.05）。两组病人各时间点的ODI、椎间隙高度、椎管面积、腰椎前凸角度比较，差异均无统计学意义（P＞0.05）。末次随访时，两组的椎间融合率均为100%，未发生严重并发症。结论 Delta椎板间内镜技术具备与开放TLIF相似的临床疗效，但前者术中创伤更小，术后疼痛更轻，平均住院日更短，值得推广。 |
| 英文摘要: |
| Objective To compare the clinical effects of the interlaminar endoscopic spine system Delta (iLESSYS Delta) and open transforaminal lumbar interbody fusion (TLIF) in the treatment of single segment lumbar instability. Methods A total of 80 patients with single segment lumbar instability who needed surgical treatment from March 2018 to March 2021 in our hospital were selected and randomly divided into an endoscopic group (40 cases) and an open group (40 cases) by a simple digital table randomization method. The operation time, incision length, intraoperative dural rupture number, postoperative hematoma number, and average hospital stay in the two groups were recorded. The Oswestry disability index (ODI) and visual analogue scale (VAS) were used to evaluate the function and pain of the patients before surgery, at 1 month and 3 months after surgery, and at last follow-up. The intervertebral space height, spinal canal area, lumbar lordosis angle and vertebral fusion at the last follow-up were recorded at each time point. Results All patients successfully completed the operation. Compared with the open group, the endoscopic group had longer operation time, shorter incision length, shorter hospital stay, and the differences between the groups were statistically significant (P＜0.05). One case (2.5%) of dural rupture occurred in the open group during the operation, and the patient recovered and was discharged after symptomatic treatment. There were no cases of hematoma after operation in the two groups. Postoperative follow-up of patients was (11.63±3.70) months (6-18 months). The VAS scores of the endoscopic group at 1 month and 3 months after operation were significantly higher than those of the open group, and the difference was statistically significant (P＜0.05). There was no significant difference in ODI, intervertebral space height, spinal canal area and lumbar lordosis angle between the two groups of patients at each time point (P＞0.05). At the last follow-up, the interbody fusion rate in both groups was 100%, and no serious complications occurred. Conclusion iLESSYS Delta technology has similar clinical efficacy to traditional TLIF, but has less intraoperative trauma, less postoperative pain, and a shorter average hospital stay, which is worthy of promotion. |
|
查看全文
下载PDF阅读器 |
| 关闭 |
|
|
|
