单侧椎弓根螺钉固定联合椎间融合术治疗腰椎间盘突出症  

Treatment of Lumbar Disc Herniation by Unilateral Pedicle Screw Fixation with Lumber Interbody Fusion

作　　者：谭健[1] 李平元[1] 欧军[1] 苏小桃[1] 卢政好[1] 

机构地区：[1]南华大学附属南华医院脊柱外科,湖南衡阳421002

出　　处：《实用骨科杂志》2015年第1期5-8,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨行单侧椎弓根螺钉固定联合椎间融合术治疗腰椎间盘突出症的临床疗效。方法回顾性分析本院2011年1月至2012年12月96例腰椎间盘突出症患者,均行单侧椎弓根螺钉固定联合椎间融合术;年龄42-68岁,平均52.3岁;采用腰腿痛视觉模拟评分测评入院时和单侧椎弓根螺钉固定联合椎间融合术后（术后1周、1个月、3个月及末次随访腰腿疼痛程度）,末次随访采用改良Mac Nab标准评定临床疗效,并行CT检查了解椎间融合情况。结果 96例患者手术后随访12-30个月,平均18.6个月。所有患者均无神经损伤和脑脊液漏并发症发生。患者术后不同时期的VAS评分与术前比较差异均有统计学意义（P〈0.01）。采用改良Mac Nab标准评价临床结果,优良率为94.79%。末次随访时行CT检查,均无内固定失效和椎间不融合发生,6例发生椎间融合器塌陷入终板,但无不适,考虑与骨质疏松或过早负重活动有关。结论单侧椎弓根螺钉固定联合椎间融合治疗腰椎间盘突出症疗效满意,具有创伤小、并发症少、费用低的优点。Objective To investigate the clinical outcomes of unilateral pedicle screw fixation with interhody fusion for the treatment of lumbar disc herniation. Methods We retrospectively investigated 96 patients suffering from lumbar disc herniation,who were treated with unilateral pediele screw fixation with lumbar interbody fusion from 2011 to 2012. Visual analogue scale （VAS） were recorded at admission and at 1 week, 1 month ,3 months and last follow-up after operation. We assessed the clinical efficacy at last follow-up according to the MacNab criteria and observed intervertebral fusion by CT. Results 96 patients were followed up 12 to 30 months after operation, average 18.6 months. All the patients had no nerve injury and leakage of cerebrospinal fluid complications. Compared with preoperative, VAS score had significant difference （ P 〈 0. 01 ） at different periods after operation. According to the modified MacNab criteria, the excellent and good rate was 94.79%. CT examination showed that there were no internal fixation failure and lumbar interbody non-fusion at the last follow-up. 6 cases of intervertebral fusion cage collapse into endplate, but no discomfort. Conclusion The unilateral pediele screw fixation combined with iuterbody fusion in the treatment of lumbar disc herniation with satisfied effect, has the advantages of small trauma, less complications, low cost.

关 键 词：腰椎间盘突出症 单侧入路 椎弓根螺钉 椎间融合术 

分 类 号：R681.53[医药卫生—骨科学]