椎间融合器联合椎弓根钉系统内固定治疗腰椎间盘突出伴椎管狭窄症  

Combined intervertebral fusion device with pedicle screw internal fixation for the treatment with lumbar disc herniation with spinal stenosis

作　　者：林国兵[1] 陈雄[1] 李秋举[1] 郭文荣[1] 李平生[1] 王怀云[1] 洪志群[1] 徐建平[1] 陈祥[1] 

机构地区：[1]南京军区福州总医院95临床部骨二区,福建莆田351100

出　　处：《颈腰痛杂志》2011年第2期96-99,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨椎间融合器联合椎弓根钉系统内固定治疗腰椎间盘突出伴椎管狭窄症的疗效。方法在2005-01-2009-02期间对18例腰椎间盘突出伴椎管狭窄症的患者采用了经椎弓根固定,全椎板切除椎管减压、单枚或双枚椎间融合器植入融合术(内固定组)。并随机抽取18例同期单纯椎板切除椎管减压及髓核摘除的此类患者作为对照组(非内固定组),采用日本骨科学会(JOA)腰腿痛疗效标准(29分法),根据术后改善率评价,对结果进行统计学分析。结果术后随访6～24个月(平均18个月),末次随访时JOA评分改善率,内固定组为73.27%±14.75%,非内固定组为47.33%±11.86%。两组数据经t检验(t=5.815,P<0.05),有统计学差异。结论全椎板切除椎管减压、椎间融合器联合椎弓根钉系统内固定治疗腰椎间盘突出伴椎管狭窄症,疗效显著,较传统方法有一定优越性,可保持椎间隙高度,腰痛缓解率高,且较少发生并发症,但内固定组费用较高,患者负担较大。Objective To discuss the efficacy of combined intervertebral fusion device with pedicle screw internal fixation method in treatment of lumbar disc herniation with spinal stenosis.Methods From January 2005 to February 2009,observations has been made in 18 patients suffered from lumbar disc herniation with spinal stenosis after treatment by combined intervertebral fusion device with pedicle screw internal fixation method for their effective rate and status of rehabilitation.The other 18 cases were treated with limited laminectomy decompression.The clinical outcome at preoperation and follow-up was analyzed by Japanese Orthopaedic Association（JOA）score.The results were put into statistical analysis.Results All patients were followed up for avcragcd 18 months（range,6 to 24 months）.The improve rate of JOA score at final followed up for each group were 73.27%±14.75%,47.33%±11.86% respectively.Which showed statistical difference among two groups（t=5.815,P0.05）.Conclusion The results of combined intervertebral fusion device with pedicle screw internal fixation method in treatment of lumbar disc herniation with spinal stenosis is more satisfactory with significant efficacy and less complication than the traditional methods.

关 键 词：腰椎间盘突出 腰椎管狭窄症 椎弓根钉固定系统 椎间融合器 

分 类 号：R681.53[医药卫生—骨科学] R687.3[医药卫生—外科学]