小切口经肌间隙入路治疗腰椎管狭窄症的临床观察.docVIP

小切口经肌间隙入路治疗腰椎管狭窄症的临床观察 　　【摘要】 目的：探讨小切口经肌间隙入路治疗腰椎管狭窄症的可行性及临床疗效。方法：选取2013年1-2014年1月本院收治的腰椎管狭窄患者56例作为研究对象，在X-tube下经肌间隙入路进行腰椎减压内固定、椎间植骨融合术，运用VAS与ODI对疗效进行评估，并于X线片上对椎间隙高度、植骨融合状况进行观察。结果：56例患者平均手术时间（57.5±3.4）min；手术切口平均长度（3.2±0.4）cm；术中平均出血量（28.5±3.7）mL；平均住院时间（6.3±1.1）d；术中未发生硬脊膜损伤。56例患者术后1月以及末次随访的VAS、ODI评分及椎间隙高度均优于术前，末次随访的VAS、ODI评分及椎间隙高度均低于术后1个月，比较差异均有统计学意义（P中国论文网 /6/view-7255079.htm 　　【关键词】 腰椎管狭窄； 肌间隙入路； 小切口； 临床疗效 　　Clinical Observation of Mini-incision Wiltse Approach in the Treatment of Lumbar Spinal Stenosis/XIE Jing-bo，WU Li-ting，YAN Yi-yun.//Medical Innovation of China，12（34）：032-035 　　【Abstract】 Objective：To explore the feasibility and clinical efficacy of mini-incision wiltse approach in the treatment of lumbar spinal stenosis.Method：56 patients with lumbar spinal stenosis in our hospital from January 2013 to January 2014 were selected as the research objects.They were given lumbar spinal decompression and internal fixation，transforaminal lumbar interbody fusion through wiltse approach under X-tube.The efficacy was evaluated by VAS and ODI.The height of fused segment and the situation of bone graft fusion on the x-ray films were observed.Result：Among the 56 patients，the mean operative time was （57.5±3.4）min，their average length of incision was （3.2±0.4）cm，their average intraoperative blood loss was （28.5±3.7）mL and their mean duration of stay was （6.3±1.1）d.Dural injury did not occur during the operation.The scores of VAS and ODI，the height of fused segment of the final follow-up and one month after the operation were better than those before treatment，the scores of VAS，ODI and the height of fused segment of the final follow-up were lower than those one month after the operation，the differences were statistically significant（P 　　1 资料与方法 　　1.1 一般资料 选取2013年1月-2014年1月本院收治的腰椎管狭窄患者56例作为研究对象，其中男 　　32例，女24例，年龄37～75岁，平均（57.3±3.6）岁，病程9个月～8年，平均（21.8±2.5）个月。临床症状及体征：56例均患有不同程度间歇性跛行与腰痛；29例在步行后其单侧下肢伴有放射痛，7例双侧伴有放射痛，6例存在小便失禁，1例存在大便失禁，8例存在双侧下肢无力，23例下肢感觉有所减退；直腿抬高试验：13例单侧为阳性，5例双侧为阳