吴文坚;梁裕;张兴凯;曹鹏;陈新用;郑涛;

• 1:上海交通大学医学院附属瑞金医院骨科 上海市伤骨科研究所

摘要(Abstract)：

背景:微创腰椎经椎间孔入路椎间融合(MIS-TLIF)被广泛应用于腰椎退变的手术治疗并取得了良好的临床效果,但微创手术可能增加并发症的风险。目的:总结MIS-TLIF的发生,并探讨并发症的发生原因和相关对策。方法:对2010年1月至2011年5月间行MIS-TLIF手术的连续131例病例进行回顾分析。记录患者的手术时间,术中出血量,术后住院时间,并发症情况。并在术前、术后3个月以及末次随访时以VAS评分评估患者手术前后腰痛的程度,以Oswestry伤残指数和JOA评分评估患者的功能。结果:平均随访8.3个月;所有患者平均手术时间为(146.4±36.9)min,平均术中出血(176.7±86.1)ml,术后平均住院时间为(4.4±1.6)d;患者术后3个月及最后随访时腰痛及功能状况均较术前有明显的改善;16人次(12.2%)出现并发症:伤口局部血肿1例(0.8%);硬膜撕裂6例(4.6%);椎弓根螺钉位置欠佳6枚(1.0%);1例不明原因足下垂(0.8%);1例79岁患者术后出现肺部感染(0.8%);1例76岁患者术后出现尿潴留(0.8%)。结论:微创腰椎经椎间孔椎体间融合术治疗腰椎退变性疾病安全、可靠,并发症的发生主要与MIS-TLIF的手术特点、学习曲线及患者的选择有关,应重视MIS-TLIF手术技术的培训,严格掌握适应证,以减少相关并发症的发生。只要进行严格的筛选和术前准备,老年患者也可进行微创手术的治疗。

关键词(KeyWords)： 微创脊柱外科手术;经椎间孔椎体间融合术;并发症;学习曲线

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 吴文坚;梁裕;张兴凯;曹鹏;陈新用;郑涛;

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