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经皮椎弓根螺钉前后路腰椎体间融合术:与肌肉损伤和微创手术的比较。

Anterior and posterior lumbar interbody fusion with percutaneous pedicle screws: comparison to muscle damage and minimally invasive techniques.

机构信息

Neurosurgery Research Foundation of Texas, Plano, TX, USA.

出版信息

Spine (Phila Pa 1976). 2009 Dec 1;34(25):E923-5. doi: 10.1097/BRS.0b013e3181af0523.

Abstract

STUDY DESIGN

Retrospective analysis of patients whom underwent one-level anterior lumbar interbody fusion or posterior lumbar interbody fusion with percutaneous pedicle screws.

OBJECTIVE

To determine which minimally invasive fusion technique, anterior or posterior lumbar fusions, induces the least amount of muscle damage.

SUMMARY OF BACKGROUND DATA

Creatine phosphokinase is recognized as a good marker for muscle damage occurring in patients after spine surgery. Minimally invasive fusions are known to reduce the amount of muscle damage. Which surgery induces the least amount of muscle damage is yet to be determined.Minimally invasive spine surgery is becoming increasing popular due to the benefits of less muscle damage, shorter hospital length and quicker recovery. Lumbar fusions are one of the most common surgeries and is becoming less invasive with the use of percutaneous pedicle screws.

METHODS

Seventy-four patients whom underwent either anterior or posterior lumbar interbody fusions with percutaneous pedicle screws had preoperative and postoperative creatine kinase levels. Statistical analysis then compared the average change between the 2 groups.

RESULTS

Minimally invasive anterior lumbar interbody fusions with percutaneous pedicle screws had significantly less muscle damage (P < 0.05) than minimally invasive posterior lumbar interbody fusions with percutanoues screws.

CONCLUSION

Minimally invasive anterior lumbar interbody fusions with percutaneous pedicle screws cause significantly less muscle damage than minimally invasive posterior lumbar interbody fusions with percutaneous screws. Furthermore minimally invasive anterior lumbar body interbody fusions demonstrated near the same amount of muscle damage to previously published literature on lumbar microdikectomies.

摘要

研究设计

回顾性分析接受单节段前路腰椎椎间融合术或后路腰椎椎间融合术联合经皮椎弓根螺钉固定的患者。

目的

确定微创融合技术,前路或后路腰椎融合术,引起的肌肉损伤最小。

背景资料概要

肌酸磷酸激酶被认为是脊柱手术后患者肌肉损伤的良好标志物。微创融合术已知可减少肌肉损伤的程度。哪种手术引起的肌肉损伤最小尚未确定。由于微创脊柱手术具有肌肉损伤小、住院时间短、恢复快等优点,因此越来越受欢迎。腰椎融合术是最常见的手术之一,随着经皮椎弓根螺钉的应用,其微创程度也在不断提高。

方法

74 例接受前路或后路腰椎椎间融合术联合经皮椎弓根螺钉固定的患者均有术前和术后肌酸激酶水平。然后,统计分析比较了两组之间的平均变化。

结果

微创前路腰椎椎间融合术联合经皮椎弓根螺钉固定术引起的肌肉损伤明显小于微创后路腰椎椎间融合术联合经皮螺钉固定术(P<0.05)。

结论

微创前路腰椎椎间融合术联合经皮椎弓根螺钉固定术引起的肌肉损伤明显小于微创后路腰椎椎间融合术联合经皮螺钉固定术。此外,微创前路腰椎体间融合术与先前发表的腰椎小关节切除术文献相比,肌肉损伤程度相近。

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