不同手术方法治疗多节段腰椎间盘退变疾病的中长期疗效评价  

A Middle-long Term Follow-up Results of Different Surgical Treatment Methods for Multiple Lumbar Disc Disease

作　　者：袁维[1] 李熙雷[1] 董健[1] 周晓岗[1] 马易群[1] 周健[1] 王会仁[1] 

机构地区：[1]复旦大学附属中山医院骨科,上海市200032

出　　处：《中国骨与关节损伤杂志》2011年第9期769-771,共3页Chinese Journal of Bone and Joint Injury

基　　金：上海市医学重点项目(09411953800);上海市科委"科技创新行动计划"重点项目(08411952500);上海市"优秀学科带头人"计划(07XD14006);上海市医学领军人才项目(LJ10017)

摘　　要：目的探讨不同手术方法治疗多节段腰椎间盘退变疾病的临床效果。方法对自2004年6月～2008年1月收治的302例多节段腰椎间盘退变性疾病,均一期行腰椎后路手术,分别给予单纯开窗髓核摘除、后路椎间融合术(PLIF)、经椎间孔腰椎间融合术(TLIF)、棘突间动态固定系统(Coflex)、腰椎后路动态钉棒固定系统(Semi-Rigid Rod)等不同手术方法以及TLIF与Coflex,动态钉棒固定与TLIF相结合等术式。结果随访时间10～36个月,平均20.3个月,所有患者腰腿痛症状得到有效缓解,椎间植骨融合良好,无断钉及融合器移位等并发症。结论多节段腰椎间盘退变性疾病的治疗需要根据不同患者的年龄、症状、体征及患者自身的要求选择不同的手术方案。动态固定与融合手术相结合是未来的发展方向。Objective To investigate the clinical outcomes of different surgical treatment methods for the multiple lumbar disc disease. Methods From Jun. 2004 to Jan. 2008, 302 patients with multiple lumbar disc disease underwent one stage of lumbar posterior surgery and were treated with difference of microsurgical discectomy, PLIF with cages, TLIF with cages, Coflex with cages,Semi-Rigid Rod with cages,TLIF with cages plus Coflex, and TLIF with cages plus Semi-Rigid Rod. Results The follow-up time was 10 to 36 months （aver- age 20.3 months）, the leg and back pain was relieved effectively after the operation. The interbody fusion was weU without screw breakage and loosing. Conclusion The choice of different surgery in multiple lumbar disc disease based on the patient＇s age, symptoms and signs, and the needs of patient＇s own requirement. Dynamic fixation combined with fusion surgery is the developmental direction in the future.

关 键 词：腰椎间盘 退变性疾病 多节段 

分 类 号：R681.5[医药卫生—骨科学]