小切口椎板开窗微创术联合腰椎内固定植骨融合术治疗腰椎间盘突出合并腰椎不稳临床疗效观察  

Small Incision Fenestration Minimally Invasive Surgery Combined with Lumbar Laminectomy and Fusion Fixation in Treatment of Lumbar Disc Herniation with Lumbar Instability

作　　者：邵擎东[1] 江峰[1] 蒋贵成 段俊[1] 严旭[1] 张明河[1] 

机构地区：[1]中国人民解放军第455医院骨科,上海200052

出　　处：《河北医学》2014年第6期931-934,共4页Hebei Medicine

摘　　要：目的:探讨小切口椎板开窗微创术联合腰椎内固定植骨融合术治疗腰椎间盘突出合并腰椎不稳的临床应用价值。方法:本院2007年1月至2012年1月共80例腰椎间盘突出合并腰椎不稳的患者,均予椎板切除减压同时行腰椎内固定加椎间植骨融合术,按照手术方式不同进行分组,其中行小切口椎板开窗微创术联合腰椎内固定植骨融合术40例(A组),全椎板切除术联合腰椎内固定植骨融合术40例(B组)。回顾性分析两组临床资料及术后随访材料,比较其术中表现及术后疗效。结果:A组患者的切口长度、手术时间、术中出血量及卧床时间均显著小于B组患者,差异具有统计学意义(P<0.05);经手术治疗后,A组患者治疗的有效率以及术后6个月ODI指数改善35分以上的人数显著高于B组,神经根损伤的发生率显著低于B组,差异具有统计学意义(P<0.05)。结论:小切口椎板开窗微创术联合腰椎内固定植骨融合术具有手术时间短、创伤轻、融合率高、恢复快等优点,值得在临床上推广应用。Objective：To investigate the clinical applications of small incision fenestration minimally in-vasive surgery combined with lumbar laminectomy and fusion fixation in treatment of lumbar disc herniation with lumbar instability .Method：A total of 80 patients of lumbar disc herniation with lumbar instability were divided into two groups according to different operation .The group A had the small incision fenestration mini-mally invasive surgery combined with lumbar fixation and fusion , and the group B had the lumbar laminecto-my surgery combined with internal fixation and fusion .Result：The incision length , operative time , blood loss and bed time of the patients in group A were less than those in group B , the difference was statistically signif-icant （P 〈0.05）;after surgery, the efficiency of the surgery and the number of patients whose ODI scores improved 35 points in group A were significantly higher than that in the group B after six months , the inci-dence of nerve root injury was lower than in group B , the difference was statistically significant （ P 〈0.05） . Conclusion：Small incision fenestration minimally invasive surgery combined with lumbar laminectomy and fusion fixation treatment has shorter operation time , milder trauma , higher fusion rate , quicker recovery , etc, it is worthy of clinical application .

关 键 词：小切口椎板开窗微创术 腰椎内固定植骨融合术 腰椎间盘突出 腰椎不稳 

分 类 号：R687.3[医药卫生—骨科学]