椎弓根钉内固定椎间植骨融合术治疗复发性椎间盘突出合并腰椎不稳症  

Treatment of recurrent lumbar disc herniation (RLDH) combined with lumbar instability with pedicle screws fixation and interbody fusion

作　　者：黄立成[1] 方文广[1] 余金胜[1] 李建军[1] 杜贵忠[1] 杨希宝 

机构地区：[1]广东省惠州市惠阳区人民医院,516001

出　　处：《中国实用医药》2009年第35期38-39,共2页China Practical Medicine

摘　　要：目的观察椎弓根钉内固定椎间植骨治疗复发性椎间盘突出合并腰椎不稳症的临床疗效。方法58例复发性椎间盘突出合并腰椎不稳的患者再次翻修手术采用扩大椎管减压、椎间植骨、椎弓根螺钉内固定方式进行治疗。术后对所有患者进行日本矫形外科学会(JOA)下腰痛评分标准问卷调查及影像学随访观察。结果本组未见内固定物松动,所有病例脊柱节段均获融合,融合率100%,平均融合时间为8(6～12)个月。术后随访1～5年,症状均有明显改善,优良率为96.6%。结论复发性腰椎间盘突出症合并腰椎不稳经扩大椎管减压、椎弓根螺钉固定、椎间植骨,治疗后效果较为满意。Objective To investigate clinical results of pedicale screws fixation and interbody fusion for recurrent lumbar disc herniation （RLDH） combined with lumbar instability. Methods 58 cases of recurrent lumbar disc herniation combined with lumbar instability were treated with vertebral canal decompression, pedicle screws fixation and interbody fusion. The outcomes of the treatmentwere assessed by X-ray and JOA scores questionaire. Results None showed the phenomenon of the loosening of internal fixation cinch in this group, the lumbar of the whole case all had been anfuenced. The rate of confluence was 100%. The average time of the lumbar confluensed was 8 （ 6 - 12） months. The 58 cases with surgical operation were followed- up from 1 to 5 year. The symptoms of 58 cases were greatly improved. The good rate was 96. 6%. Condnsion The satisfactory effectiveness of the reoperation of RLDH combined with lumbar instability can be acquired by vertebral canal deeompression, pedicle screws fixation and interbody fusion.

关 键 词：椎弓根螺钉内固定 复发性椎间盘突出症 腰椎不稳 椎间植骨 

分 类 号：R687.3[医药卫生—骨科学]