| 王伟,兰魁勇,苑强,等.一种新型脊柱提拉复位辅助装置在腰椎Ⅱ度滑脱术中的应用.骨科,2025,16(4): 298-303. |
| 一种新型脊柱提拉复位辅助装置在腰椎Ⅱ度滑脱术中的应用 |
| Application of a new spinal lifting and reduction assistive device in the management of grade Ⅱ lumbar spondylolisthesis |
| 投稿时间：2025-02-25 |
| DOI：DOI：10.3969/j.issn.1674-8573.2025.04.002 |
| 中文关键词: 腰椎滑脱症 脊柱提拉复位装置 单边双通道内镜技术 腰椎间融合术 |
| 英文关键词: Lumbar spondylolisthesis Spinal lifting and reduction assistive device Unilateral biprotal endoscopic technique Lumbar interbody fusion |
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| 中文摘要: |
| 目的 评价一种新型脊柱提拉复位辅助装置在单侧双通道脊柱内镜下经椎间孔腰椎融合手术（unilateral biprotal endoscopic transforaminal lumbar interbody fusion，UBE-TLIF）治疗Ⅱ度腰椎滑脱中的应用效果。方法 从2022年3月至2024年3月于我院诊断为Ⅱ度腰椎滑脱症且需要手术治疗的病人中选取40例，随机分为观察组和对照组：对照组男4例，女16例，年龄为（61.64±7.96）岁，采用常规UBE-TLIF；观察组男7例，女13例，年龄为（58.77±9.95）岁，应用新型提拉复位装置行UBE-TLIF手术。分别记录并比较两组病人手术时间、出血量、疼痛视觉模拟量表（visual analogue score，VAS）评分、Oswestry功能障碍指数（Oswestry disability index，ODI）、改良MacNab标准评分，以及手术前后椎间隙高度、椎体滑移距离。结果 两组病人均顺利完成手术，均获得随访，随访时间为（17.60±2.96）个月（12~21个月）。观察组术中出血量明显少于对照组［（148.75±29.32）mL vs. （238.50±67.84）mL］，差异有统计学意义（P＜0.05）。两组术后VAS评分、ODI均较术前显著下降，且观察组术后1个月的VAS评分显著低于对照组［（0.35±0.49）分 vs. （0.95±0.60）分］，术后1周、1个月的ODI显著低于对照组（19.80%±2.50% vs. 22.55%±4.32%，14.25%±2.19% vs. 16.35%±2.73%），差异有统计学意义（P＜0.05）；但两组病人术后各个阶段的改良MacNab评分对比，差异无统计学意义（P＞0.05）。两组椎间隙高度、椎体滑移距离较术前均明显改善，对照组术后1周、1个月和6个月的椎体滑移距离均大于观察组，差异有统计学差异（P＜0.05）；两组术后椎间隙高度差异无统计学意义（P＞0.05）。结论 在UBE-TLIF治疗Ⅱ度腰椎滑脱症手术过程中应用该新型脊柱提拉复位装置，可显著提高滑脱复位程度，安全有效，值得推广应用。 |
| 英文摘要: |
| Objective To evaluate the applied value of a new spinal lifting and reduction assistive device in the treatment of grade Ⅱ lumbar spondylolisthesis using unilateral biprotal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF). Methods A total of 40 patients diagnosed with grade Ⅱ lumbar spondylolisthesis requiring surgical treatment were selected in our hospital from March 2022 to March 2024. They were randomly assigned to the observation group and the control group. There were 4 males and 16 females in the control group, aged (61.64±7.96) years, who were treated with conventional UBE-TLIF. There were 7 males and 13 females in the observation group, with an age of (58.77±9.95) years, who underwent UBE-TLIF surgery using a new spinal lifting and reduction assistive device. The surgical time, amount of blood loss, visual analogue score (VAS), Oswestry disability index (ODI), modified MacNab criteria score, as well as the intervertebral space height and vertebral spondylolisthesis rang before and after surgery were recorded and compared between the two groups. Results Both groups of patients underwent surgery smoothly. All patients were followed up for a period of (17.60±2.96) months (ranging from 12 to 21 months). The observation group had significantly less intraoperative blood loss than the control group ［(148.75±29.32) mL vs. (238.50±67.84) mL］ and the difference was statistically significant (P＜0.05). The postoperative VAS scores and ODI scores in both groups after surgery showed significant improvement compared to those preoperation, with the VAS scores in the observation group at 1st month postoperatively showing lower values than the control group (0.35±0.49 vs. 0.95±0.60), and the ODI scores in the observation group at 1st week, 1st month postoperatively were significantly decreased compared to the control group (19.80%±2.50% vs. 22.55%±4.32%, 14.25%±2.19% vs. 16.35%±2.73%), with statistical significance (P＜0.05). There was no statistically significant difference in the modified MacNab scores at various postoperative stages between the two groups (P＞0.05). The intervertebral space height and vertebral spondylolisthesis were significantly improved postoperatively compared to preoperative values in both groups. The vertebral spondylolisthesis rang in the control group at 1st week, 1st month, and 6th month postoperatively was significantly greater than that in the observation group (P＜0.05), while there was no statistically significant difference in the intervertebral space height between the two groups postoperatively (P＞0.05). Conclusion The application of this new spinal lifting and reduction assistive device in the surgical process of UBE-TLIF treatment for grade Ⅱ lumbar spondylolisthesis can significantly improve the degree of spondylolisthesis reduction safely and effectively, and is worthy of promotion and application. |
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