Clinical efficacy of Wiltse approach combined with modified TILF technique in the treatment of moderate to severe lumbar spondylolisthesis

PU Jungang; WANG Tengyu; WANG Zhong; FAN Weili; LIU Peng; ZHAO Jianhua

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Clinical efficacy of Wiltse approach combined with modified TILF technique in the treatment of moderate to severe lumbar spondylolisthesis

更新时间：2022-06-24

- Clinical efficacy of Wiltse approach combined with modified TILF technique in the treatment of moderate to severe lumbar spondylolisthesis
- null Issue 8, Pages: 630(2020)
- 作者机构：
  
  陆军军医大学特色医学中心脊柱外科,重庆,400042
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PU Jungang, WANG Tengyu, WANG Zhong, et al. Clinical efficacy of Wiltse approach combined with modified TILF technique in the treatment of moderate to severe lumbar spondylolisthesis. [J]. null (8):630(2020)
DOI：

PU Jungang, WANG Tengyu, WANG Zhong, et al. Clinical efficacy of Wiltse approach combined with modified TILF technique in the treatment of moderate to severe lumbar spondylolisthesis. [J]. null (8):630(2020) DOI：

摘要

目的探讨经Wiltse入路结合改良经椎间孔腰椎体间融合术(TLIF)治疗中重度腰椎滑脱症的临床疗效。方法回顾性分析2014年1月至2017年1月我科收治并获得随访的51例中重度腰椎滑脱症患者的病历资料，均采用Wiltse入路结合改良TLIF治疗。统计患者手术时间、术中出血量及术后并发症情况，影像学观察椎间隙高度、滑脱角、滑脱率及融合率，采用腰痛和下肢痛视觉疼痛模拟量表(VAS)及Oswestry功能障碍指数(ODI)评定临床疗效。结果患者手术时间99～202 min，平均（115.0±16.7）min；术中出血量101～320 mL，平均（170.8±63.6）mL。随访13～36个月，平均（21.6±5.7）个月。共3例患者出现并发症，其中1例硬脊膜撕裂，2例术后出现L5神经根麻痹症状。患者腰痛VAS评分、下肢痛VAS评分及ODI分别由术前的（6.7±1.8）分、（6.8±2.0）分、（61.7±11.6）%下降至末次随访时的（2.2±1.0）分、（1.3±1.2）分、(18.5±5.6)%，椎间隙高度由术前的（5.17±1.72）mm提高至末次随访时的（10.23±1.01）mm，滑脱角和滑脱率分别从术前的（7.03±1.82）°和(49.8±6.7)%下降至末次随访时的（1.23±0.68）°和(10.1±3.8)%，差异均有极显著性统计学意义（P＜0.01）。术后6个月49例患者获得坚强融合，2例可能融合，融合率为96.1％。结论经Wiltse入路结合改良TLIF对腰椎后部肌肉及后方韧带复合体破坏小，是一种治疗中重度腰椎滑脱症的理想微创手术方法。

Abstract

关键词

Wiltse入路经椎间孔腰椎体间融合术腰椎滑脱症后路复位神经根损伤

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