后路有限减压植骨融合内固定治疗腰椎退变性不稳的临床研究  

Clinical research of posterior limited decompression bone fusion internal fixation in treatment of lumbar degenerative instability

作　　者：吴发泳[1] 尹金铭[1] 林榕镔[1] 罗佛长 

机构地区：[1]福建省三明市第二医院骨科二区,福建三明366000

出　　处：《中国当代医药》2015年第22期62-64,69,共4页China Modern Medicine

摘　　要：目的探讨后路有限减压植骨融合内固定治疗腰椎退变性不稳的临床效果。方法选取本院2010年10月~2014年2月诊治的腰椎退变性不稳患者106例,采用随机数字表法分为两组,各53例。对照组患者采用传统后路开放手术治疗,观察组患者采用后路有限减压植骨融合内固定治疗,比较两组的治疗效果。结果观察组患者的术中出血量、术后引流量明显少于对照组,切口长度明显小于对照组,下床活动时间、术后住院时间明显短于对照组（P〈0.05）。治疗后,两组患者的Oswestry功能障碍指数（疼痛、行走、坐立、自理能力、提物、睡眠、总评分）、VAS评分均显著降低,疼痛程度均明显减轻,且观察组治疗后的Oswestry功能障碍指数（疼痛、行走、坐立、自理能力、提物、睡眠、总评分）、VAS评分明显低于对照组,疼痛程度明显轻于对照组（P〈0.05）;观察组的术后并发症发生率均明显低于对照组（P〈0.05）。结论后路有限减压植骨融合内固定是治疗腰椎退变性不稳的有效方法,具有创伤小、疼痛轻、术后恢复快、并发症少、安全性高等优点。Objective To investigate clinical effect of posterior limited decompression bone fusion internal fixation in treatment of lumbar degenerative instability. Methods 106 patients with lumbar degenerative instability diagnosed and treated in our hospital were selected from October 2010 to February 2014,and they were randomly divided into two groups,and there were 53 patients in each group.Control group was treated with traditional posterior open operation while observation group was treated with posterior limited decompression bone fusion internal fixation as observation group.Ttreatment effect was compared between two groups. Results Intraoperative bleeding volume and postoperative drainage volume in observation group was obviously less than that of control group respectively,incision length was ob-viously smaller than that of control group,and the time of getting out of bed to exercise,postoperative hospitalization time was obviously shorter than that of control group （P〈0.05）;after treatment,Oswestry dysfunction index （pain,walking, sitting,self-care ability,holding something,sleep,total score） and VAS score was decreased significantly respectively, while degree of pain was relieved obviously in two groups,and Oswestry dysfunction index （pain,walking,sitting,self-care ability,holding something,sleep,total score） and VAS score was decreased significantly respectively,while degree of pain was relieved in observation group after treatment compared with control group （P〈0.05）;the incidence rate of postopera-tive complications in observation group was significantly lower than that of control group （P〈0.05）. Conclusion Posterior limited decompression bone fusion internal fixation is an effective method in treatment of degenerative lumbar instability, which has advantages of smaller trauma,less pain,faster postoperative recovery,fewer complications,higher safety and so on.

关 键 词：后路有限减压植骨融合内固定 腰椎退变性不稳 传统后路开放手术 

分 类 号：R681.5[医药卫生—骨科学]