经皮椎弓根空心螺钉微创椎体间融合治疗腰椎间盘突出的临床效果分析  

Analysis the Clinical Effect of Posterior Interbody Fusion Under Percutaneous Hollow Pedicle Screws on Lumbar Disc Herniation

作　　者：朱明喜[1] 朱琳[1] 闫晓霞[1] 杨博辰[1] 韩崇涛[1] 

机构地区：[1]河南中医学院第三附属医院骨科,河南郑州450008

出　　处：《现代生物医学进展》2015年第27期5285-5287,5298,共4页Progress in Modern Biomedicine

基　　金：河南省科技攻关计划项目(122102310186)

摘　　要：目的：探究经皮椎弓根空心螺钉微创椎体间融合治疗腰椎间盘突出的临床效果及安全性。方法：病例来源于我院2009年12月~2013年12月收治的确诊为腰椎间盘突出症的病患174例,依据随机数字表法将其均分为观察组与对照组,每组87例。其中,观察组施行Quadrant微创通道经皮椎弓根空心螺钉椎间融合术,对照组施行经后入路开放性椎间融合术。评估和比较两组病患术前和随访结束时的视觉模拟评分系统（VAS）疼痛评分与Oswestry功能障碍指数（ODI）的变化及术后并发症的发生情况。结果：观察组治疗前、出院时及随访一年时的VAS评分与ODI指数与对照组比较差异均不显著（P〉0.05）。观察组手术切口长度、术后住院时间及术中出血量均明显优于对照组（P〈0.01）,而其手术所需时间明显长于对照组（P〈0.01）。对照组患者术后出现20例神经根损伤（22.99%）,3例椎间隙感染（3.45%）,其并发症总发生率为（26.44%）,而观察组患者术后仅出现3例神经根损伤,发生率为3.45%,显著低于对照组（P〈0.01）。结论：经皮椎弓根空心螺钉微创椎体间融合治疗的临床效果肯定,能减少对病患的创伤,控制术后并发症的发生,具有较高的临床应用价值。Objective： To explore the clinical effect and safety of posterior interbody fusion under percutaneous hollow pedicle screws on lumbar disc herniation. Methods： 174 patients diagnosed as lumbar disc herniation treated in our hospital from December 2009 to December 2009 were selected and divided into the observation group and control group according to the random number table method,137 cases in each group. The observation group was treated by the channel of Quadrant minimally invasive percutaneous pedicle screw hollow intervertebral fusion, and the control group was imposed by the open intervertebral fusion after into the road. The visual analogue scoring system（VAS） pain scores, Oswestry disability index（ODI） preoperation and at the end of follow-up visit and incidence of postoperative complications were compared between two groups. Results： No significant difference was found in the difference preoperation, on discharge and at the end of 1st follow-up visit between two groups（P〉0.05）. The operative incision length,postoperative hospital stay and intraoperative blood loss of observation group were significantly better than those of control group, and the operation time was significantly longer（P〈0.01）. 20（22.99%） cases of nerverootinjury, 3 cases of intervertebral space infection were observed in the control group after operation, the total incidence rate of complications was 26.44%, while only 3（3.45%） cases of nerverootinjury were observed in the observation group, the incidence rate was significantly lower than that of the control group（P〈0.01）.Conclusion： Posterior interbody fusion under percutaneous hollow pedicle screws had positive effect on lumbar disc herniation, which could reduce the wound, control the occurrence of postoperative complications, and had high clinical application value.

关 键 词：经皮椎弓根空心螺钉 Quadrant微创通道 腰椎间盘突出 视觉模拟评分系统(VAS)疼痛评分 

分 类 号：R681.53[医药卫生—骨科学]