内镜X-Tube系统下微创手术治疗腰椎 滑脱症的临床疗效分析

Clinical research of minimally invasive surgical management for lumbar spondylolisthesis via endoscopic (X-Tube) system

摘要:

目的 探讨内窥镜X-Tube系统联合Sextant-R系统微创治疗腰椎滑脱症的临床疗效。方法 共收治腰椎滑脱症52例，其中峡部裂型22例，退变性30例。均采用X-Tube系统下减压、植骨及融合，Sextant-R系统下进行置钉及滑脱提拉复位。采用VAS疼痛评分评估术前和术后1年的疼痛情况；采用腰椎JOA功能评分对术前及术后1年的腰椎功能进行评估、并计算改善率；术后1年复查X片评估滑脱复位率、内固定物位置及融合情况。结果 VAS评分和JOA评分术前与术后1年比较差异有显著性（P <0.05）；随访1年椎体滑脱复位率和融合率分别91.7%和94.1%，所有患者无融合器移位、沉降及椎弓根钉断裂现象。结论 X-Tube系统联合Sextant-R系统微创治疗腰椎滑脱症具有创伤小及术后恢复快等优点，是一种安全、有效的手术方法。

Abstract:

【Objective】 To analyze the effectiveness of minimally invasive surgical management for lumbar spondylolisthesis via endoscopic X-Tube system assisted Sextant-R system. 【Methods】 52 patients with lumbar spondylolisthesis included isthmic spondylolisthesis (n=22) and degenerative spondylolisthesis (n=30), were performed minimally invasive via X-Tube system for decompression and fusion, via Sextant-R system for fixation and reduction. VAS score system was used to evaluate back pain the pre-and post operative (12 months). JOA score system was used to evaluate the pre-and post operative (12 months) score and improvement rate. X-ray was used to evaluate the reduction of spondylolisthesis and the fusion rate post operative (12 months). 【Results】 The VAS and JOA score showed statistical significance (P <0.05) between preoperative and 12 months postoperation. The reduction of spondylolisthesis was 91.7%, and the fusion rate was 94.1% at 12 months postopertively. There were no cage displacement and subside, no screw fracture in all patients. 【Conclusion】 Minimally invasive surgical management for lumbar spondylolisthesis via X-Tube system assisted Sextant-R system is less injure and short recovery time with safety and effectiveness.