Zhou Wei, Li Li-Jun, Tan Jun
Department of Orthopaedics, the Affiliated Shanghai East Hospital of Tongji University, Shanghai 200120, China.
Zhongguo Gu Shang. 2010 Apr;23(4):251-3.
To investigate the effect of treating degenerative lumbar spondylolisthesis by transforaminal lumbar interbody fusion with microendoscopic surgery.
From Jan. 2006 to Jan. 2009, one hundred fifty patients who underwent transforaminal lumbar interbody fusion with microendoscopic surgery were analyzed retrospectively. The diagnosis was degenerative lumbar spondylolisthesis in 84 cases of grade I, and 66 cases of grade II. There were 88 males and 62 females. Preoperatively, at 1 week and 3 months postoperatively, the pain was evaluated with visual analogue scale (VAS) scoring system and therapeutic effect was observed with modified Prolo scoring system.
In complications, dural tear happened in 3 cases, biological glues were used for dural tear sealing and neither cerebrospinal fluid leak was found. One case suffered from intervertebral Infection and muscle weakness of foot was found in one case, either was cured after symptomatic treatment. Operative time averaged 160 minutes (120-280 min). Estimated blood loss averaged 210 ml (100-450 ml). The postoperative follow-up ranged from 6 to 36 months (averaged 15.2 months). Preoperatively,at 1 week and 3 months postoperatively, VAS scores were respectively 7.9 +/- 2.1, 2.2 +/- 0.6, 3.2 +/- 1.1 (P < 0.01). The rate of excellent and good was 98.67% (148/150) according to modified Prolo scoring system.
Microendoscopic surgery transforaminal lumbar interbody fusion technique is indicated for lumbar vertebral instability, localized intervertebral disc disorder and lumbar spondylolisthesis with stenotic nerve root or tube below grade II. This technique has advantages of minimal invasion and early functional recovery.
探讨经椎间孔腰椎椎体间融合术结合显微内镜手术治疗退变性腰椎滑脱症的效果。
回顾性分析2006年1月至2009年1月期间接受经椎间孔腰椎椎体间融合术结合显微内镜手术的150例患者。其中诊断为Ⅰ度退变性腰椎滑脱症84例，Ⅱ度66例。男性88例，女性62例。术前、术后1周及3个月，采用视觉模拟评分（VAS）系统评估疼痛情况，并采用改良Prolo评分系统观察治疗效果。
并发症方面，3例发生硬脊膜撕裂，使用生物胶封闭硬脊膜撕裂处，未发现脑脊液漏。1例发生椎间感染，1例出现足部肌肉无力，经对症治疗后均治愈。手术时间平均160分钟（120 - 280分钟）。估计失血量平均210毫升（100 - 450毫升）。术后随访6至36个月（平均15.2个月）。术前、术后1周及3个月，VAS评分分别为7.9±2.1、2.2±0.6、3.2±1.1（P < 0.01）。根据改良Prolo评分系统，优良率为98.67%（148/150）。
显微内镜下经椎间孔腰椎椎体间融合技术适用于腰椎不稳、局限性椎间盘病变以及Ⅱ度以下伴有神经根或神经根管狭窄的腰椎滑脱症。该技术具有创伤小、功能恢复早的优点。
