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首页> 外文期刊>Orthopaedic surgery >Mini‐invasive Transforaminal Lumbar Interbody Fusion through Wiltse Approach to Treating Lumbar Spondylolytic Spondylolisthesis
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Mini‐invasive Transforaminal Lumbar Interbody Fusion through Wiltse Approach to Treating Lumbar Spondylolytic Spondylolisthesis

机译：Wiltse法微创经椎间孔腰椎椎体间融合术治疗腰椎滑脱性腰椎滑脱

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Objective To assess the clinical efficacy of mini-invasive transforaminal lumbar interbody fusion (TLIF) through the Wiltse approach for treating lumbar spondylolytic spondylolisthesis. Methods In this retrospective controlled study, 69 cases with lumbar spondylolytic spondylolisthesis treated in Qilu hospital from April to November 2014 were randomly assigned to Wiltse approach (31 cases, 16 male, 15 female; mean age 45.1 years) and traditional approach groups (38 cases, 21 male, 17 female; 47.2 years. In the Wiltse approach group, the affected level was Lsub4, 5/sub in 19 cases and Lsub5/subSsub1/sub in 12, 9 of whom had low back pain (LBP) only and 21 both LBP and leg pain. There were 17 cases of I degree and 14 of II degree spondylolisthesis. Pre-operative Japanese Orthopedic Association (JOA) score was 13.1 ± 2.6; visual analog scale (VAS) for LBP 7.4 ± 1.2; VAS for leg pain 6.1 ± 2.0 and Oswestry disability index (ODI) score 42.2% ± 1.2%. In the traditional approach group, the affected level was Lsub4, 5/sub in 22 cases and Lsub5/subSsub1/sub in 16, 11 of whom had LBP only and 27 both LBP and leg pain. There were 21 cases of I degree and 17 of II degree spondylolisthesis. Pre-operative JOA score was 12.8 ± 1.2; VAS for LBP 6.9 ± 1.1; VAS for leg pain 7.1 ± 2.0 and ODI score 41.2% ± 2.0%. The JOA score, VAS for LBP and leg pain, ODI dynamic X-rays, CT and/or MR were evaluated 3 and 6 months and 1 year postoperatively. Results There were no differences in sex, age, affected levels, spondylolisthesis degree, pre-operative JOA score, VAS for LBP or leg pain and ODI score between the two groups ( P 0.05). The incision length, blood loss and time to achieving exposure were better in the Wiltse approach than the traditional approach group ( P 0.05). The interbody fusion rate was not significantly different between the groups ( P 0.05). There were no complications of internal fixation in either group. Conclusion TLIF via both approaches has satisfactory clinical efficacy. TLIF through the Wiltse approach significantly reduces the damage of multifidus and postoperative incidence of chronic LBP.
机译：目的通过Wiltse方法评估微创经孔椎间孔腰椎椎体间融合术（TLIF）治疗腰椎滑脱性腰椎滑脱的临床疗效。方法采用回顾性对照研究方法，将齐鲁医院2014年4月至2014年11月收治的69例腰椎椎弓峡部滑脱症患者随机分为Wiltse入路（男31例，男16例，女15例;平均年龄45.1岁），传统组38例。 ，男性21例，女性17例; 47.2岁。在Wiltse方法组中，受影响的水平为L 4、5 19例和L 5 S 1 < / sub> 12位患者中，仅9位具有下腰痛（LBP），LBP和腿部疼痛均21位，其中I级17例，II型脊椎滑脱14例，术前日本骨科协会（JOA）得分为13.1±2.6; LBP的视觉模拟量表（VAS）7.4±1.2;腿痛的VAS评分6.1±2.0和Oswestry残疾指数（ODI）评分为42.2％±1.2％。在传统方法组中，受影响水平为L 4、5 22例，L 5 S 1 16例，其中仅LBP 11例，LBP和腿痛27例，其中21例I度和II度腰椎滑脱的17。术前JOA评分为12.8±1.2; LBP的VAS 6.9±1.1;腿痛的VAS为7.1±2.0，ODI评分为41.2％±2.0％。术后3个月，6个月和1年评估JOA评分，LBP和腿痛的VAS，ODI动态X射线，CT和/或MR。结果两组之间在性别，年龄，患病水平，腰椎滑脱程度，术前JOA评分，LBP或腿痛的VAS和ODI评分方面无差异（P> 0.05）。 Wiltse入路的切口长度，失血量和达到接触的时间比传统入路组要好（P 0.05）。两组之间的椎体间融合率无显着差异（P> 0.05）。两组均无内固定并发症。结论TLIF两种方法均具有满意的临床疗效。通过Wiltse方法的TLIF可显着降低多发性纤维瘤的损害和慢性LBP的术后发生率。

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