单侧入路双侧减压技术对腰椎退变性椎间盘疾病的治疗效果

Abstract
Figure/Table
References (20)
Related Citation (15)

Download: PDF (627 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To compare the clinical effect and imaging results of bilateral decompression via a unilateral approach technique and transforaminal lumbar interbody fusion in the treatment of senile lumbar degenerative disc disease. Methods A total of 60 patients with senile lumbar degenerative disc disease who underwent surgery in the Department of Orthopaedics, Shantou Central Hospital from January 2017 to April 2020 were retrospectively selected as research objects. According to different surgical methods, they were divided into bilateral decompression via a unilateral approach (BDUA) group and transforaminal lumbar interbody fusion (TLIF) group, with 30 cases in each group. Operation-related complications, the operation time, intraoperative blood loss, drainage volume, hospital stay and other indicators were compared between the two groups. The preoperative and postoperative Japan Orthopedic Association(JOA), visual analogue scale (VAS) and Oswestry disability index (ODI) scores were compared between the two groups.The fusion rate at 3 months after operation was compared between the two groups. Results The intraoperative blood loss, postoperative drainage volume in the BUDA group were less than those in TLIF group, and VAS score at 3 months after operation in the BUDA group was lower than that in the TLIF group, the differences were statistically significant(P<0.05). There were no significant differences in JOA score and ODI score between the two groups before and after operation (P>0.05). There were no significant differences in fusion rate and lumbar lordosis between the two groups after operation (P>0.05). The fusion rate and lumbar lordosis at 6, 12 months after operation in the two groups were higher than those at 3 month after operation, the differences were statistically significant (P<0.05). Conclusion Bilateral decompression via a unilateral approach has more advantages in reducing intraoperative blood loss, postoperative drainage volume and early postoperative pain.

Key words： Bilateral decompression via a unilateral approach Lumbar degenerative disc disease Interbody fusion Elderly patients

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	CHEN Zhanpeng
	HU Yishan
	LIU Weijun
	LIN Mianlong
	LIN Bendan

Cite this article:

CHEN Zhanpeng,HU Yishan,LIU Weijun, et al. Therapeutic effect of bilateral decompression via a unilateral approach technique on lumbar degenerative disc disease[J]. 中国当代医药, 2022, 29(27): 78-82.

URL:

https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I27/78

[1]	Mueller KB，Garrett CT，Kane S，et al.Incidental Durotomy Following Surgery for Degenerative Lumbar Disease and the Impact of Minimally Invasive Surgical Technique on the Rate and Need for Surgical Revision：A Case Series[J].Oper Neurosurg（Hagerstown），2021，21（5）：351-355.
[2]	程良才，张文聪，王志旭.椎弓根钉内固定加骨水泥灌注椎体成形治疗老年退行性腰椎疾病的临床疗效研究[J].中国医药科学，2020，10（6）：255-258.
[3]	Siccoli A，Schrder ML，Staartjes VE.Influence of dynamic preoperative body mass index changes on patient-reported outcomes after surgery for degenerative lumbar spine disease[J].Neurosurg Rev，2021，44（5）：2689-2696.
[4]	Pei H，Wang H，Chen M，et al.Surgical site infection after posterior lumbar interbody fusion and instrumentation in patients with lumbar degenerative disease[J].Int Wound J，2021，18（5）：608-615.
[5]	Zeitlberger AM，Sosnova M，Ziga M，et al.Assessment of the Minimum Clinically Important Difference in the Smartphonebased 6-minute Walking Test After Surgery for Lumbar Degenerative Disc Disease[J].Spine（Phila Pa 1976），2021，46（18）：E959-E965.
[6]	Caton MT，Wiggins WF，Pomerantz SR，et al.The Composite Severity Score for Lumbar Spine MRI：a Metric of Cumulative Degenerative Disease Predicts Time Spent on Interpretation and Reporting[J].J Digit Imaging，2021，34（4）：811-819.
[7]	Kaye AD，Edinoff AN，Temple SN，et al.A Comprehensive Review of Novel Interventional Techniques for Chronic Pain：Spinal Stenosis and Degenerative Disc Disease-MILD Percutaneous Image Guided Lumbar Decompression，Vertiflex Interspinous Spacer，MinuteMan G3 Interspinous-Interlaminar Fusion[J].Adv Ther，2021，38（9）：4628-4645.
[8]	Huang Y，Chen J，Gao P，et al.A comparison of the bilateral decompression via unilateral approach versus conventional approach transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disc disease in the elderly[J].BMC Musculoskelet Disord，2021，22（1）：156-158.
[9]	Xin Z，Huang P，Zheng G，et al.Using a percutaneous spinal endoscopy unilateral posterior interlaminar approach to perform bilateral decompression for patients with lumbar lateral recess stenosis[J].Asian J Surg，2020，43（5）：593-602.
[10]	耿文东，赖淑珍，梁建义.正骨推拿联合针灸在退行性腰椎滑脱症患者中的应用及对其JOA 评分的影响[J].中医临床研究，2021，13（15）：106-107，111.
[11]	于斌，黄笑蕾.Tight Rope 和空心钉内固定对Lisfranc 损伤患者术后各时点VAS 评分及AOFAS 评分的影响[J].中外医疗，2021，40（20）：40-42，46.
[12]	张明娟，王娟，黄黎黎，等.中医特色护理对腰椎间盘突出症患者腰椎生理曲度、ODI 评分的影响[J].中国医学创新，2020，17（15）：94-97.
[13]	Lee JH，Lee JH，Park JW，et al.Fusion rates of a morselized local bone graft in polyetheretherketone cages in posterior lumbar interbody fusion by quantitative analysis using consecutive three-dimensional computed tomography scans[J].Spine J，2011，11（7）：647-653.
[14]	Khan AA，Iliescu DD，Sneath RJ，et al.Principal component and factor analysis to study variations in the aging lumbar spine[J].IEEE J Biomed Health Inform，2015，19（2）：745-751.
[15]	Bach K，Ford J，Foley R，et al.Morphometric Analysis of Lumbar Intervertebral Disc Height：An Imaging Study[J].World Neurosurg，2018，124（5）：e106-118.
[16]	Malahias MA，Gu A，Richardson SS，et al.Association of Lumbar Degenerative Disease and Revision Rate following Total Knee Arthroplasty[J].J Knee Surg，2021，34（10）：1126-1132.
[17]	Hildebrandt M，Fankhauser G，Meichtry A，et al.Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain[J].BMC Musculoskelet Disord，2017，18（1）：12.
[18]	Xie Q，Zhang J，Lu F，et al.Minimally invasive versus open Transforaminal lumbar Interbody fusion in obese patients：a meta-analysis[J].BMC Musculoskelet Disord，2018，19（1）：15.
[19]	Young S，Veerapen R，O′Laoire SA.Relief of lumbar canal stenosis using multilevel subarticular fenestrations as an alternative to wide laminectomy：preliminary report[J].Neurosurgery，1988，23（5）：628-633.
[20]	Heider FC，Mayer HM.[Unilateral approach for over the top bilateral lumbar decompression][J].Oper Orthop Traumatol，2019，31（6）：513-535.