后路单侧和双侧内固定治疗腰椎间盘突出症临床疗效  

Clinical effect of posterior unilateral or bilateral internal fixation on lumbar disc herniation

作　　者：梁亮[1] 甫拉提.买买提 张健[1] 盛伟斌[1] 

机构地区：[1]新疆医科大学第一附属医院脊柱外科,乌鲁木齐830054

出　　处：《中华实用诊断与治疗杂志》2015年第2期148-151,共4页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的评价后路单、双侧内固定治疗腰椎间盘突出症的临床疗效。方法 46例腰椎间盘突出症患者分为2组,行腰椎后路单侧内固定18例为单侧固定组,行双侧内固定28例为双侧固定组。比较2组手术时间、术中出血量、住院费用及术后住院时间;2组采用疼痛视觉模拟评分(visual analogue scale,VAS)、Oswesty功能障碍指数评分(Oswestry disability index,ODI)进行临床疗效评价。结果单侧固定组手术时间((113.84±12.49)min)短于双侧固定组((177.92±7.92)min)(P<0.05),术中出血量((189.47±140.02)mL)、术后住院时间((6.47±1.71)d)与双侧固定组((225.20±114.93)mL、(7.28±1.67)d)比较差异无统计学意义(P>0.05);术后单侧固定组、双侧固定组VAS、ODI评分分别为(2.44±0.62)、(25.44±1.95),(2.84±0.90)、(25.11±2.05),均较术前(6.39±1.24、65.06±6.43,6.76±1.16、65.78±7.08)明显降低(P<0.01或P<0.05),但组间比较差异无统计学意义(P>0.05);单侧固定组1例术后5d发现内固定位置不佳,后经调整置钉位置恢复,2组术后均未发生内固定松动、断钉等并发症。结论腰椎后路单、双侧内固定均可有效改善腰椎间盘突出症患者腰痛及下肢疼痛症状,单侧固定在手术时间方面更具优势。Objective To evaluate posterior unilateral or bilateral internal fixation on lumbar disc herniation.Methods In 46 patients with lumbar disc herniation,18 patients received unilateral internal fixation（unilateral group）,and the other 28 patients received bilateral fixation（bilateral group）.The operation duration,intraoperative blood loss and postoperative hospitalization stay were compared between two groups.The clinical effect was evaluated by visual analogue scale（VAS）and Oswestry disability index score（ODI）.Results The operation duration was shorter in unilateral group（（113.84±12.49）min）than that in bilateral group（（177.92±7.92）min）（P〈0.05）.There were no significant differences in intraoperative blood loss and postoperative hospitalization stay between unilateral group（（189.47±140.02）mL,（6.47±1.71）days）and bilateral group（（225.20±114.93）mL,（7.28±1.67）days）（P〉0.05）.VAS and ODI scores were significantly lower after operation in unilateral group（2.44±0.62,25.44±1.95）and bilateral group（2.84±0.90,25.11±2.05）than those before operation（6.39±1.24,65.06±6.43;6.76±1.16,65.78±7.08）（P〈0.01,P〈0.05）,showing no significant differences between two groups（P〉0.05）.Fixation dislocation occurred in one patient in unilateral group in 5days after operation,which was improved after adjusting the position of screw.No loosening and breakage were found after operation.Conclusion Both unilateral and bilateral fixation can effectively relieve low-back pain and leg pain in patients with lumbar disc herniation.Unilateral fixation is superior to bilateral fixation in shortening the operation duration.

关 键 词：腰椎椎间盘突出症 手术 内固定 

分 类 号：R687.3[医药卫生—骨科学]