经椎间孔腰椎间融合治疗腰椎间盘突出症术后复发的临床疗效  

Treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

作　　者：蔡成成[1] 王经韬[1] 郭天庆 

机构地区：[1]兰州市第二人民医院骨科,甘肃兰州730046 [2]榆中县马坡乡银山中心卫生院,甘肃兰州730100

出　　处：《甘肃医药》2013年第7期511-514,共4页Gansu Medical Journal

摘　　要：目的:探讨经椎间孔后路腰椎间融合内固定治疗腰椎间盘突出症术后复发的临床疗效。方法:2005年5至2011年6月我院应用经椎间孔后路腰椎间融合内固定治疗腰椎间盘突出症术后复发的患者27例,男15例,女12例;年龄31～56岁,平均为45.3岁。采用Macnab疗效评定标准评估治疗效果。结果:本组均获随访,随访时间18～60个月,平均36个月。优19例,良4,可3例,差1例,优良率为88.5%。患者术后3～6个月植骨均融合,平均4.5个月。随访期间椎弓根螺钉无松动、断裂,融合器位置及形态正常。结论:经椎间孔腰椎间融合、椎弓根螺钉内固定术能够明显缓解腰椎间盘突出症术后复发患者症状及改善相关功能障碍,降低了手术的并发症的发生,是治疗腰椎间盘突出症术后复发的理想方法。Objective：Toevaluate the clinical results of recurrent lumbar disc herniation by posterior transforaminal lumbar in terbody fusion （TLIF）plus internal fixation. Methods：From May 2005 to June 2011,27 patients of recurrent lumbar disc herniation who had been treated by the method of TLIF and internal fixation were collected in this study,with 15 males and 12 females and the mean age of 45.3 years. The clinical results of all patients were analyzed according to Macnab’s criterion. Results：All patients were followed up for 36 months（range 6 months～60months）. There were excellent in 19 cases,good in 4 cases,fair in 3 cases and poor in 1case. The satisfactory rate was 88.5%. The bony fusions were observed 3～6 months（on average 4.5 months）after operation. No loosening or breakage happened to pedicle screws. Interbody fusion cages stayed with normal location and shape. Conclusion：The application of TLIF in the treatment of patients with recurrent lumbar disc herniation can obviously relieve the symptoms and impove the functional disturbances. Meanwhile,TLIF can reduce the occurrence of the complications and is regarded the ideal method of treatment of recurrent lumbar disc herniation.

关 键 词：腰椎间盘突出症 复发 再手术 经椎间孔椎体间融合 

分 类 号：R681.53[医药卫生—骨科学]