【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)

MinimallyInvasiveTransforaminalLumbarInterbodyFusion(TLIF)

DRSEANG-BENGTAN

HEAD,DEPTOFORTHOPAEDICS

DIRECTOR,SPINESERVICE

SINGAPOREGENERALHOSPITAL

微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)

新加坡中央醫(yī)院MinimallyInvasiveTransforaAimofMIS

微創(chuàng)的目的Accomplishsurgicalgoalsthroughsmallincisionsandminimaldisruptionofnormaltissues以小切口達(dá)到手術(shù)的目的，并對(duì)正常組織造成最少的傷害。AimofMIS

微創(chuàng)的目的AccomplishsurPrinciplesofMinimallyInvasiveSpinalSurgery

微創(chuàng)脊椎手術(shù)的原則DecompressandstabilizethespineReducethe“surgicalinjury”tonormaltissuesLimitretractionofmuscle減壓并保持脊椎穩(wěn)定減少對(duì)正常組織的傷害減少對(duì)肌肉的拉扯PrinciplesofMinimallyInvasiReducebloodlossImproverecoverybyreducingpostoperativepain減少失血量減輕術(shù)后疼痛，以使病人盡快康復(fù)。PrinciplesofMinimallyInvasiveSpinalSurgery

微創(chuàng)脊椎手術(shù)的原則ReducebloodlossPrinciplesofNewAdvancesinTLIF

經(jīng)椎間孔入路腰椎體間融合術(shù)的最新動(dòng)向PercutaneousdecompressionandcageplacementwithPipelineandothertubesystemsPercutaneouspediclescrewfixationusingViper,Sextant,Pathfinder經(jīng)皮穿刺減壓和利用工作通道來(lái)放置椎間融合器利用Viper,Sextant,Pathfinder，經(jīng)皮植入椎弓根螺釘。NewAdvancesinTLIF

經(jīng)椎間孔入路腰椎體StrategiestoAvoidComplicationswithMIS

微創(chuàng)手術(shù)中減少并發(fā)癥的策略Training培訓(xùn)Patientselection選擇適當(dāng)?shù)牟∪薙etup設(shè)備Access入路Pediclescrewplacement椎弓根螺釘?shù)闹踩隡isc

其他策略StrategiestoAvoidComplicatiTraining

培訓(xùn)THEREISALEARNINGCURVE!!學(xué)習(xí)的過(guò)程CadaverworkshopsViewcaseswithsurgeonwelltrainedinapplyingthesetechniquesStartslowlyandworkuptomorecomplexcases在尸體上練習(xí)在熟練醫(yī)生進(jìn)行這類手術(shù)時(shí)觀摩循序漸進(jìn)，慢慢地過(guò)渡到復(fù)雜的手術(shù)。Training

培訓(xùn)THEREISALEARNINGTraining

培訓(xùn)Startbigandmovesmaller-graduallyreduceincisionsizeStartinthelumbarspineBecomecomfortablewithmicrodiscectomyfirstLearnkyphoplasty由大的切口開(kāi)始，慢慢地縮小切口由腰椎開(kāi)始先從熟悉顯微椎間盤切除術(shù)入手學(xué)習(xí)球囊擴(kuò)張椎體后凸成形術(shù)Training

培訓(xùn)StartbigandmovePatientSelection

選擇適當(dāng)?shù)牟∪薓ISfusionpatients–primarilyonesegmentdiseaseDDD–somediscspacepreservationGrade1tolowGrade2spondylolisthesisBewareofL5-S1(sacrumsometimehardtovisualizepediclescrewtargeting)微創(chuàng)融合術(shù)的病人–由單間隙的病患開(kāi)始椎間盤退化-椎間距離不宜太小第一級(jí)的腰椎滑脫或輕微第二級(jí)的腰椎滑脫小心L5-S1間隙（在骶骨植入椎弓根螺釘會(huì)比較困難）PatientSelection

選擇適當(dāng)?shù)牟∪薓ISfStartwithrelativelythinindividualswithgoodbonequalityObesityandosteoporosis–difficulttovisualizebonyanatomyadequately從骨質(zhì)相對(duì)比較好和較廋的病人開(kāi)始肥胖和骨質(zhì)疏松癥–使骨骼較難充分暴露PatientSelection

選擇適當(dāng)?shù)牟∪薙tartwithrelativelythinind【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)TLIFAccess

椎間融合器入路WorkingZone操作區(qū)域Accessosteotomy入路截骨TLIFAccess

椎間融合器入路WorkingZonDecompresstheipsilateralside,thenputinthelargestcage,beforedecompressingcontralateralside.

同側(cè)減壓先。然后，在另一側(cè)減壓前，植入最大的椎間融合器。Decompresstheipsilateralsid【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)Nerve神經(jīng)Pediclescrewplacement植入椎弓根螺釘NervePediclescrewplacementPercutaneousScrewAngulation經(jīng)皮調(diào)整螺釘?shù)慕嵌萂OVELATERAL!向外側(cè)移動(dòng)！PercutaneousScrewAngulationMStartingPoint起點(diǎn)StartingPointPedicleMidPoint植入椎弓中途PedicleMidPointThruthePedicle完全植入ThruthePedicle【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)Ensurescrewheadsareatthesamelevel

螺釘頭要固定在同一水平線上Ensurescrewheadsareatthe【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)微創(chuàng)和開(kāi)放性經(jīng)椎間孔入路腰椎體間融合術(shù)的

6個(gè)月與2年隨訪調(diào)查SpineService,OrthopaedicSurgerySingaporeGeneralHospital脊椎專科，矯形外科新加坡中央醫(yī)院ProspectiveTrialofMISTLIFVsOPENTLIF–6Months&2yearsResult微創(chuàng)和開(kāi)放性經(jīng)椎間孔入路腰椎體間融合術(shù)的

6個(gè)月與2年隨訪調(diào)

MIS微創(chuàng)OPEN開(kāi)放型Age年齡(years)58.458.5Sex性別

(F:M)(女:男)116:6512:3Fluoroscopytime透視時(shí)間1min45secs35secsDurationofSurgery

手術(shù)時(shí)間（小時(shí)）3:19(range:2:15–4:40)2:40(range:2–3:55)Bloodloss失血量200ml500ml

MISOPENAge年齡(years)58.458.5

MIS微創(chuàng)OPEN開(kāi)放性Lengthofhospitalisation(days)住院時(shí)間（天）4.4(range:2–9)6.0(range:5-7)VAS:POD/DISCHARGE視覺(jué)模擬疼痛評(píng)分：術(shù)后/出院5.0/1.06.0/2.6TotalMorphine(PCA,mg)嗎啡(止痛藥）劑量17.435.7Ambulation:Room/Ward(POD)術(shù)后第幾天開(kāi)始步行1.0/2.03/4

MISOPENLengthofhospitalisatNorthAmericanSpineScore

BackPain&DisabilityScore

北美脊椎協(xié)會(huì)評(píng)分標(biāo)準(zhǔn)疼痛及殘疾指數(shù)BACKPAIN&DISABILITY(Range0to100)0=Nobackpainordisability100=Maximumbackpainordisability疼痛及殘疾指數(shù)(0至100分)0=沒(méi)有疼痛或殘疾100=非常疼痛或極度殘疾開(kāi)放性微創(chuàng)術(shù)前術(shù)后六個(gè)月術(shù)后兩年NorthAmericanSpineScore

BacNorthAmericanSpineScore

NeurogenicSymptomScore

北美脊椎協(xié)會(huì)評(píng)分標(biāo)準(zhǔn)

神經(jīng)性癥狀指數(shù)NEUROGENICSYMPTOMS(Range0to100)0=Noneurogenicsymptoms100=Severeneurogenicsymptoms開(kāi)放性微創(chuàng)術(shù)前術(shù)后六個(gè)月神經(jīng)性癥狀指數(shù)(0至100分)0=沒(méi)有神經(jīng)性癥狀100=極度神經(jīng)性癥狀術(shù)后兩年NorthAmericanSpineScore

NeuNorthAmericanSpineScore(6mths)

北美脊椎協(xié)會(huì)評(píng)分標(biāo)準(zhǔn)

到現(xiàn)在為止,手術(shù)符合你的要求嗎?(術(shù)后六個(gè)月)開(kāi)放性微創(chuàng)符合多多少少不符合NorthAmericanSpineScore(6mNorthAmericanSpineScore(2yrs)

北美脊椎協(xié)會(huì)評(píng)分標(biāo)準(zhǔn)

到現(xiàn)在為止,手術(shù)符合你的要求嗎?(術(shù)后兩年)開(kāi)放性微創(chuàng)符合多多少少不符合NorthAmericanSpineScore(2yNorthAmericanSpineScore(6mths)

北美脊椎協(xié)會(huì)評(píng)分標(biāo)準(zhǔn)

你怎樣評(píng)價(jià)手術(shù)對(duì)治療你的腿或背痛的療效?(術(shù)后六個(gè)月)開(kāi)放性微創(chuàng)優(yōu)中差NorthAmericanSpineScore(6mNorthAmericanSpineScore(2yrs)

北美脊椎協(xié)會(huì)評(píng)分標(biāo)準(zhǔn)

你怎樣評(píng)價(jià)手術(shù)對(duì)治療你的腿或背痛的療效?(術(shù)后兩年)開(kāi)放性微創(chuàng)優(yōu)中差NorthAmericanSpineScore(2yNorthAmericanSpineScoreReturntoFullFunction

北美脊椎協(xié)會(huì)評(píng)分標(biāo)準(zhǔn)病人恢復(fù)工作能力開(kāi)放性微創(chuàng)術(shù)后六個(gè)月術(shù)后兩年NorthAmericanSpineScoreRetVisualAnaloguePainScaleBackpain

視覺(jué)模擬疼痛評(píng)分背痛開(kāi)放性微創(chuàng)術(shù)前術(shù)后六個(gè)月平均分?jǐn)?shù)術(shù)后兩年VisualAnaloguePainScaleBacVisualAnaloguePainScaleLeg

pain

視覺(jué)模擬疼痛評(píng)分腿痛開(kāi)放性微創(chuàng)術(shù)前術(shù)后六個(gè)月平均分?jǐn)?shù)術(shù)后兩年VisualAnaloguePainScaleLegThankYou謝謝！ThankYou

MinimallyInvasiveTransforaminalLumbarInterbodyFusion(TLIF)

DRSEANG-BENGTAN

HEAD,DEPTOFORTHOPAEDICS

DIRECTOR,SPINESERVICE

SINGAPOREGENERALHOSPITAL

微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)

新加坡中央醫(yī)院MinimallyInvasiveTransforaAimofMIS

微創(chuàng)的目的Accomplishsurgicalgoalsthroughsmallincisionsandminimaldisruptionofnormaltissues以小切口達(dá)到手術(shù)的目的，并對(duì)正常組織造成最少的傷害。AimofMIS

微創(chuàng)的目的AccomplishsurPrinciplesofMinimallyInvasiveSpinalSurgery

微創(chuàng)脊椎手術(shù)的原則DecompressandstabilizethespineReducethe“surgicalinjury”tonormaltissuesLimitretractionofmuscle減壓并保持脊椎穩(wěn)定減少對(duì)正常組織的傷害減少對(duì)肌肉的拉扯PrinciplesofMinimallyInvasiReducebloodlossImproverecoverybyreducingpostoperativepain減少失血量減輕術(shù)后疼痛，以使病人盡快康復(fù)。PrinciplesofMinimallyInvasiveSpinalSurgery

微創(chuàng)脊椎手術(shù)的原則ReducebloodlossPrinciplesofNewAdvancesinTLIF

經(jīng)椎間孔入路腰椎體間融合術(shù)的最新動(dòng)向PercutaneousdecompressionandcageplacementwithPipelineandothertubesystemsPercutaneouspediclescrewfixationusingViper,Sextant,Pathfinder經(jīng)皮穿刺減壓和利用工作通道來(lái)放置椎間融合器利用Viper,Sextant,Pathfinder，經(jīng)皮植入椎弓根螺釘。NewAdvancesinTLIF

經(jīng)椎間孔入路腰椎體StrategiestoAvoidComplicationswithMIS

微創(chuàng)手術(shù)中減少并發(fā)癥的策略Training培訓(xùn)Patientselection選擇適當(dāng)?shù)牟∪薙etup設(shè)備Access入路Pediclescrewplacement椎弓根螺釘?shù)闹踩隡isc

其他策略StrategiestoAvoidComplicatiTraining

培訓(xùn)THEREISALEARNINGCURVE!!學(xué)習(xí)的過(guò)程CadaverworkshopsViewcaseswithsurgeonwelltrainedinapplyingthesetechniquesStartslowlyandworkuptomorecomplexcases在尸體上練習(xí)在熟練醫(yī)生進(jìn)行這類手術(shù)時(shí)觀摩循序漸進(jìn)，慢慢地過(guò)渡到復(fù)雜的手術(shù)。Training

培訓(xùn)THEREISALEARNINGTraining

培訓(xùn)Startbigandmovesmaller-graduallyreduceincisionsizeStartinthelumbarspineBecomecomfortablewithmicrodiscectomyfirstLearnkyphoplasty由大的切口開(kāi)始，慢慢地縮小切口由腰椎開(kāi)始先從熟悉顯微椎間盤切除術(shù)入手學(xué)習(xí)球囊擴(kuò)張椎體后凸成形術(shù)Training

培訓(xùn)StartbigandmovePatientSelection

選擇適當(dāng)?shù)牟∪薓ISfusionpatients–primarilyonesegmentdiseaseDDD–somediscspacepreservationGrade1tolowGrade2spondylolisthesisBewareofL5-S1(sacrumsometimehardtovisualizepediclescrewtargeting)微創(chuàng)融合術(shù)的病人–由單間隙的病患開(kāi)始椎間盤退化-椎間距離不宜太小第一級(jí)的腰椎滑脫或輕微第二級(jí)的腰椎滑脫小心L5-S1間隙（在骶骨植入椎弓根螺釘會(huì)比較困難）PatientSelection

選擇適當(dāng)?shù)牟∪薓ISfStartwithrelativelythinindividualswithgoodbonequalityObesityandosteoporosis–difficulttovisualizebonyanatomyadequately從骨質(zhì)相對(duì)比較好和較廋的病人開(kāi)始肥胖和骨質(zhì)疏松癥–使骨骼較難充分暴露PatientSelection

選擇適當(dāng)?shù)牟∪薙tartwithrelativelythinind【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)TLIFAccess

椎間融合器入路WorkingZone操作區(qū)域Accessosteotomy入路截骨TLIFAccess

椎間融合器入路WorkingZonDecompresstheipsilateralside,thenputinthelargestcage,beforedecompressingcontralateralside.

同側(cè)減壓先。然后，在另一側(cè)減壓前，植入最大的椎間融合器。Decompresstheipsilateralsid【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)Nerve神經(jīng)Pediclescrewplacement植入椎弓根螺釘NervePediclescrewplacementPercutaneousScrewAngulation經(jīng)皮調(diào)整螺釘?shù)慕嵌萂OVELATERAL!向外側(cè)移動(dòng)！PercutaneousScrewAngulationMStartingPoint起點(diǎn)StartingPointPedicleMidPoint植入椎弓中途PedicleMidPointThruthePedicle完全植入ThruthePedicle【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)Ensurescrewheadsareatthesamelevel

螺釘頭要固定在同一水平線上Ensurescrewheadsareatthe【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)【骨科-微創(chuàng)-課件】微創(chuàng)經(jīng)椎間孔入路腰椎體間融合術(shù)微創(chuàng)和開(kāi)放性經(jīng)椎間孔入路腰椎體間融合術(shù)的

6個(gè)月與2年隨訪調(diào)查SpineService,OrthopaedicSurgerySingaporeGeneralHospital脊椎?？?，矯形外科新加坡中央醫(yī)院ProspectiveTrialofMISTLIFVsOPENTLIF–6Months&2yearsResult微創(chuàng)和開(kāi)放性經(jīng)椎間孔入路腰椎體間融合術(shù)的

6個(gè)月與2年隨訪調(diào)

MIS微創(chuàng)OPEN開(kāi)放型Age年齡(years)58.458.5Sex性別

(F:M)(女:男)116:6512:3Fluoroscopytime透視時(shí)間1min45secs35secsDurationofSurgery

手術(shù)時(shí)間（小時(shí)）3:19(range:2:15–4:40)2:40(range:2–3:55)Bloodloss失血量200ml500ml

MISOPENAge年齡(years)58.458.5

MIS微創(chuàng)OPEN開(kāi)放性Lengthofhospitalisation(days)住院時(shí)間（天）4.4(range:2–9)6.0(range:5-7)VAS:POD/DISCHARGE視覺(jué)模擬疼痛評(píng)分：術(shù)后/出院5.0/1.06.0/2.6TotalMorphine(PCA,mg)嗎啡(止痛藥）劑量17.435.7Ambulation:Room/Ward(POD)術(shù)后第幾天開(kāi)始步行1.0/2.03/4

MISOPENLengthofhospitalisatNorthAmericanSpineScore

BackPain&DisabilityScore

北美脊椎協(xié)會(huì)評(píng)分標(biāo)準(zhǔn)疼痛及殘疾指數(shù)BACKPAIN&DISABILITY(Range0to100)0=Nobackpainordisability100=Maximumbackpainordis