Teng Haijun, Wang Liang, Guo Zhiliang, Fan Lijing, Zhang Dahai, Zhang Wei, Wang Shidong
2nd Department of Orthopaedics, 89th Hospital of PLA, Weifang Shandong 261021, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 May;24(5):517-20.
To evaluate the effect of posterior lumbar interbody fusion (PLIF) using single incision via MAST Quadrant retractor in the management of lumbar spondylolisthesis.
From July 2008 to June 2009, 20 cases of lumbar spondylolisthesis were treated with posterior lumbar interbody fusion via MAST Quadrant retractor using single incision, including 2 cases of degenerative spondylolisthesis and 18 cases of isthmic spondylolisthesis. There were 8 males and 12 females aged from 34 to 62 years (average 45.5 years). The disease course was 1 to 6 years (mean 34.5 months). The spondylolisthesis locations were L4, 5 in 8 cases and L5, S1 in 12 cases. According to Meyerding classification, all cases were classified as degree I. The Visual Analogue Scale (VAS) score was (6.6 +/- 1.2) points. The operative time, the blood loss, and the therapeutic effects were recorded.
The operative time was (155 +/- 23) minutes and the amount of blood loss was (360 +/- 102) mL. The hospitalization time were (12.0 +/- 3.4) days. All incisions healed by first intention. X-ray films showed spondylolisthesis reduction immediately after operation. All patients were followed up 14.3 months on average (from 9 to 20 months). The VAS score decreased to (1.6 +/- 2.3) points at the last follow-up, showing significant difference when compared with that of preoperation (P < 0.05). The X-ray films showed that lumbar interbody fusion was achieved in all the patients. No loosening, breakage, and displacement of pedicle screw fixation was observed. According to Nakai standard, the results were excellent in 18 cases and good in 2 cases at the last follow-up.
As long as the indication is strictly chosen, PLIF via MAST Quadrant retractor is a safe, effective, and minimally invasive surgical technique in treating lumbar spondylolisthesis.
评估采用MAST Quadrant撑开器单切口后路腰椎椎间融合术（PLIF）治疗腰椎滑脱症的效果。
2008年7月至2009年6月，采用MAST Quadrant撑开器单切口后路腰椎椎间融合术治疗20例腰椎滑脱症患者，其中退行性腰椎滑脱症2例，峡部裂性腰椎滑脱症18例。男8例，女12例，年龄34～62岁，平均45.5岁。病程1～6年，平均34.5个月。腰椎滑脱部位：L4、5节段8例，L5、S1节段12例。按Meyerding分级，均为Ⅰ度。视觉模拟评分法（VAS）评分为（6.6±1.2）分。记录手术时间、出血量及治疗效果。
手术时间为（155±23）分钟，出血量为（360±102）ml。住院时间为（12.±3.4）天。所有切口均一期愈合。术后X线片显示腰椎滑脱复位。所有患者平均随访14.3个月（9～20个月）。末次随访时VAS评分降至（1.6±2.3）分，与术前比较差异有统计学意义（P<0.05）。X线片显示所有患者均获得腰椎椎间融合。未观察到椎弓根螺钉固定松动、断裂及移位。末次随访按Nakai标准评定：优18例，良2例。
只要严格掌握适应证，采用MAST Quadrant撑开器行PLIF治疗腰椎滑脱症是一种安全、有效、微创的手术技术。
