经Quadrant通道下经肌间隙入路治疗腰椎间盘突出症的效果及对腰椎功能恢复疼痛程度及影像学参数的影响

doi:10.3969/j.issn.1006-6233.2024.05.020

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Abstract Objective: To explore the effect of intermuscular approach under Quadrant channel in the treatment of lumbar disc herniation (LDH) and its influence on lumbar function recovery, pain degree and imaging parameters. Methods: A total of 102 patients with LDH who were scheduled to undergo transforaminal lumbar interbody fusion (TLIF) in our hospital were enrolled from March 2020 to March 2023, and were divided into observation group (51 cases) and control group (51 cases) by adopting random number table method. The control group was treated with TLIF through traditional open approach, and the observation group was given TLIF through intermuscular approach under Quadrant channel. The surgical conditions of the two groups were compared. MacNab standard was used to evaluate the postoperative rehabilitation effect. Oswestry disability index (ODI) and low back pain numerical rating scale (NRS) were applied to assess the lumbar function recovery and pain degree before surgery and at 1 week, 3 months and 6 months after surgery. The changes in lumbar-pelvic sagittal imaging parameters [lumbar lordosis angle (LL), lumbosacral angle (LSA), pelvic tilt angle (PT), sacral slope (SS) and pelvic incidence angle (PI)] were compared before surgery and at 6 months after surgery, and the complications of the two groups were observed. Results: The surgical time and postoperative ambulation time in observation group were shorter (P<0.05), and the intraoperative blood loss and postoperative drainage volume were less than those in control group (P<0.05). At 6 months after surgery, the excellent and good rate of 98.04% was significantly higher than 84.32% in control group (P<0.05). ODI score and lumbar pain NRS score showed statistically significant differences in inter-group effect, time effect, and interaction between grouping and time (P<0.05). Both scores exhibited a decreasing trend over time, with a more pronounced decreasing trend observed in the observation group (P<0.05). At 6 months after surgery, the LL angle significantly decreased compared to the preoperative values in both groups, and the decrease was more pronounced in the observation group than in the control group (P<0.05), but there were no obvious differences in LSA, PT, SS and PI between the two groups (P>0.05). At 6 months after surgery, the total incidence rate of complications was significantly lower in observation group than that in control group (P<0.05). Conclusion: Compared with TLIF through traditional open approach, TLIF through intermuscular pproach under Quadrant channel for LDH has smaller trauma, simpler operation and faster recovery of postoperative lumbar function, and it is helpful to further reduce the pain degree and improve the lumbar stability, and it has high safety.

Key words： Quadrant channel Lumbar disc herniation Lumbar function Pain Imaging parameters

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	LI Bin
	CAI Jinlei
	TIAN Jun
	et al

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LI Bin,CAI Jinlei,TIAN Jun, et al. Effect of Intermuscular Approach under Quadrant Channel in Treating Lumbar Disc Herniation and Its Influence on Lumbar Function Recovery, Pain Degree and Imaging Parameters[J]. HeBei Med, 2024, 30(5): 814-819.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.05.020 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I5/814

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