人工髓核置换术治疗腰椎间盘突出症的近期临床疗效观察  

Clinical Effectiveness of Prosthetic Disc Nucleus Replacement in Treatment of Lumbar Disc Herniation

作　　者：王洪伟 叶军 苏训同 宋连兴 

机构地区：[1]广东省东莞市东华医院骨科,523000

出　　处：《中国骨与关节损伤杂志》2006年第12期959-961,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的 探讨人工髓核置换术治疗腰椎间盘突出症的近期临床应用效果。方法 自2004年3月～2004年5月，笔者采用人工髓核置换术治疗腰椎间盘突出症25例，23例经标准后侧入路单枚PDN植入，1例经横突间入路单枚PDN植入，1例经腹膜后入路单枚PDN植入。术后随访6～18个月。结果 1例术后1周出现剧烈腰痛，摄片示PDN位置好，给予卧床、镇痛、脱水治疗后缓解；1例术后4周出现腰腿痛，摄片示PDN部分移位于椎管，二次手术取出PDN行融合术后症状缓解；1例术后1个月PDN部分塌陷入椎体内，偶有腰痛，对症治疗，症状缓解。X线片复查手术后椎间隙高度平均增加3．34mm。腰椎各方活动基本正常，根据Oswestry下腰痛和功能不利评分，临床成功率84％，无感染等并发症。结论 人工髓核置换术治疗腰椎间盘突出症在改善症状的同时能够增加椎间高度，保留腰椎的正常运动功能，为腰椎间盘突出症的手术治疗提供了一种新方法。Objective To investigate clinical effectiveness of prosthetic disc nucleus （PDN） replacement in the treatment of lumbar disc herniation. Methods Twenty - five patients with lumbar disc herination were treated with PDN replacement from March 2004 to May 2004. The standard posterior approach was used in 23 patients. The intertransverse process approach was used in 1 patients and the lateroanterior retroperitoneal approach was employed in 1 patient. All patients were implanted with a single PDN . All patients were followed up 6 to 18 months （average 12.4 months）. Results One patient had a bad recovery with low back pain after one week. The position of PDN was correct in the X - ray. The symptoms disappeared after treatment. The displacement of PDN into the spinal canal was observed in 1 patient with low back pain associated with radicular leg pain after four weeks and the symptoms disappeared after the second operation. The PDN was partially collapsed into the vertebral body after one month in one patient causing slight low back pain. Based on Oswestry low back pain and disability scores, the clinical successful rate was 84%. No infection occurred. Conclusion PDN replacement can improve clinical symptoms, increase disc height and restore the normal lumbar motion as well as. Its clinical effectiveness is excellent in short- term observation.

关 键 词：人工髓核 置换 腰椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学]