摘要
[目的]探讨微创腰椎横突成形术治疗Bertolotti综合征的适应证、方法和早期疗效.[方法]2006年4月～2008年12月,于METRX X-Tube扩张套管下,应用微创腰椎横突成形术共治疗Bertolotti综合征患者13例.男4例,女9例;年龄24～43岁,平均34岁,Santavirta分型均为I型,病程1～6年,平均3.4年.采用VAS评分、ODI评分及末次随访时患者主观感觉对疗效进行判定.[结果]术中失血120～800 ml,手术时间60～280 min(平均115 min),无严重的手术合并症.9例患者获得长期随访,随访时间10～18个月(平均13.6个月).VAS评分由术前的(6.7±2.2)分,降为术后1周(2.2±0.7)分, 3个月时(2.8±0.9)分;ODI评分由术前的(27.8±3.6)分降为术后3个月的(5.9±2.2)分.与术前相比差异具有统计学意义(P<0.01).末次随访疗效评定:优10例,良3例,优良率100%.[结论]微创腰椎横突成形术适用于I型Bertolotti综合征患者,与传统方法相比,具有操作简单,出血少、损伤小等优点,对合并椎间盘突出症的患者可I期进行手术处理.
Abstract
[Objective] To gain more insight into the presentation, diagnosis of Bertolotti's syndrome and to investigate the indications, the procedure and the early clinical results of minimally invasive transverse process plasty. [Methods] Thirteen cases (Santavirta Type I) with Bertolotti' s syndrome underwent minimally invasive transverse process plasty under MED X -tube (Medtronic Sofamor) from Apr. 2006 to Dec. 2008. The Visual Analogue Scale (VAS), Modified Oswestry Disability Index (ODI) score and subjective sensation of patients were recorded to evaluate the function. [ Results] The operation blood loss was from 120 ml to 800 ml and operative time was from 60 to 280 minutes, average 115minutes . There was no severe complication. Nine cases were followed up for 10 tol8 months, average 13. 6 months. The VAS decreased from (6. 7±2. 2) before operation to (2. 2±0. 7 ) one week after operation and (2. 8±0. 9) three months after operation. ODI score decreased from (27. 8±3. 6) before operation to (5. 9±2. 2) three months after operation. The results were excellent in 10 case and good in 3 cases. [Conclusion] Minimally invasive transverse process plasty is an effective method for Bertolottis syndrome, especially for Santavirta type I. It shows less blood loss and injury and deserves to be spreaded. Disectomy is recommended in one stage if the patient is complicated with disc herniation.
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NSTL
维普
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