微创经椎间孔腰椎椎体间融合术对腰椎矢状面影响早期影像学研究.docVIP

微创经椎间孔腰椎椎体间融合术对腰椎矢状面影响早期影像学研究 　　[摘要]目的 研究微创经椎间孔腰椎椎体间融合术（TLIF）术对腰椎退变（腰椎间盘突出症、腰椎管狭窄症、腰椎滑脱）矢状位参数改变影响的早期影像学并探讨其临床意义。方法 选择2009年6月～2016年6月在我院收治的腰椎退行性疾病患者156例，所有患者均行单节段微创TLIF术。对患者术前、术后3 d及术后3个月的椎间隙高度（DH），腰椎前凸角（LL），骨盆入射角（PI），骨盆倾斜角（PT），骶骨倾斜角（SS），L1铅垂线与S1距离（LASD）等参数进行观察。结果 腰椎间盘突出症患者术后3 d和术后3个月的LL、LASD、DH优于术前，差异有统计学意义（P0.05）；退变性腰椎管狭窄症患者术后3天和术后3个月的LL、LASD、DH优于术前，差异有统计学意义（P0.05）；退变性腰椎滑脱症患者术后3 d和术后3个月的LL、PT、SS、LASD、DH优于术前，差异有统计学意义（P0.05）。结论 微创TLIF术早期有助于改善和维持腰椎矢状面序列，微创TLIF有进一步临床推广意义。 　　[关键词]微创；TLIF；腰椎矢状面参数；早期影像学改变；X线 　　[中图分类号] R682 [文献标识码] A [文章编号] 1674-4721（2017）12（a）-0071-04 　　[Abstract]Objective To study the early imaging of the effect of minimally invasive transforaminal lumbar interbody fusion （TLIF） on the changes of sagittal parameters of lumbar degeneration （lumbar disc herniation，lumbar spinal stenosis， lumbar spondylolisthesis） and to explore its clinical significance.Methods The clinical data of 156 patients with lumbar degenerative disease who were admitted to our hospital from June 2009 to June 2016 were retrospectively collected.All patients were given single-segment minimally invasive TLIF.Parameters such as intervertebral height （DH），lumbar lordosis angle （LL），pelvic incident angle （PI），pelvic tilt angle （PT），sacral tilt angle （SS），L1 plumb line and S1 distance （LASD） and other parameters were observed before surgery，3 days and 3 months after surgery.Results LL，LASD and DH were superior to those before operation at 3 days and 3 months after operation in the patients with lumbar disc herniation，and the differences were statistically significant （P0.05）；LL，LASD and DH were superior to those before operation at 3 days and 3 months after operation in the patients with degenerative lumbar spinal stenosis， and the differences were statistically significant （P0.05）；LL，PT，SS，LASD and DH were superior to those at 3 days and 3 months after operation in the patients with degenerative lumbar spondylolisthesis，and the differences were statistically significant （P0.05）.Conc