Wang Shaofei, Chao Jianhu, Wei Jianmin, Diaz Fernando G
Department of Orthopedics, Baoji Hospital of Traditional Chinese Medicine, Baoji Shaanxi, 721003, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Jun;26(6):703-7.
To evaluate the short-term effectiveness of local laminectomy and interlaminar lumbar instrumented fusion (ILIF) through a small incision for lumbar spinal stenosis.
Between November 2009 and January 2011, 16 patients with lumbar spinal stenosis were treated by local laminectomy and ILIF through a small incision. There were 7 males and 9 females with an average age of 52.8 years (range, 49-67 years). Sixteen patients had lumbar degenerative stenosis with an average disease duration of 4 years and 7 months (range, 2 years-9 years and 4 months). Four cases complicated by lateral recessus stenosis, 3 by lumbar disc herniation. Involved segments included L3,4 in 2 cases, L4,5 in 4 cases, L5, S1 in 4 cases, L3,4 and L4,5 (double segments) in 2 cases, L4,5 and L5, S1 (double segments) in 4 cases. The effectiveness was evaluated with the pre- and post-operative Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI). The cross-sectional areas of spinal canal were measured by CT scanning and were compared between pre- and post-operation.
The average operative time was 47 minutes (range, 35-80 minutes); the average blood loss was 145 mL (range, 120-350 mL); and the average hospitalization days were 7.8 days (range, 4-15 days). Cerebrospinal fluid leakage occurred in 1 case, and healing of incisions by first intention was achieved in the others. The patients were followed up 12-22 months (mean, 14.8 months). CT scanning showed interspinous fusion in 14 cases and possible fusion in 2 cases after operation, with an average fusion time of 4.6 months (range, 3-10 months). The postoperative VAS score, ODI, and cross-sectional area were significantly improved when compared with preoperative values (P < 0.05).
The ILIF can promote fusion between spinous processes, provide spine stabilization, and protect the spinal cord. The procedure has small incision, simple method of fixation and fusion.
评估局部椎板切除术和经小切口行椎间孔腰椎融合术（ILIF）治疗腰椎管狭窄症的短期疗效。
2009年11月至2011年1月，16例腰椎管狭窄症患者接受了局部椎板切除术和经小切口行ILIF治疗。其中男性7例，女性9例，平均年龄52.8岁（范围49 - 67岁）。16例患者均为腰椎退变性狭窄，平均病程4年7个月（范围2年 - 9年4个月）。4例合并侧隐窝狭窄，3例合并腰椎间盘突出症。受累节段包括L3、4共2例，L4、5共4例，L5、S1共4例，L3、4和L4、5（双节段）共2例，L4、5和L5、S1（双节段）共4例。采用术前和术后视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）评估疗效。通过CT扫描测量椎管横截面积，并比较术前和术后情况。
平均手术时间为47分钟（范围35 - 80分钟）；平均失血量为145毫升（范围120 - 350毫升）；平均住院天数为7.8天（范围4 - 15天）。1例发生脑脊液漏，其余患者切口均一期愈合。患者随访12 - 22个月（平均14.8个月）。术后CT扫描显示14例棘突间融合，2例可能融合，平均融合时间为4.6个月（范围3 - 10个月）。与术前相比，术后VAS评分、ODI及椎管横截面积均有显著改善（P < 0.05）。
ILIF可促进棘突间融合，提供脊柱稳定性并保护脊髓。该手术切口小，固定和融合方法简单。
