应用膨胀性椎间融合器治疗复发性腰椎间盘突出症的康复护理  

Rehabilitation nursing of expandable intervertebral cage in treating recurrent lumbar disc herniation

作　　者：严晓云[1] 李玉伟[1] 温艳[1] 

机构地区：[1]漯河医学高等专科学校第一附属医院脊柱科,河南漯河462000

出　　处：《中国现代医学杂志》2015年第36期85-89,共5页China Journal of Modern Medicine

基　　金：漯河医学高等专科学校自然科学基金项目(No:2014-S-LMC17)

摘　　要：目的探讨后路小切口下应用膨胀性椎间融合器微创手术治疗复发性腰椎间盘突出症的康复护理方法。方法 2012年5月-2013年12月对该院42例复发性腰椎间盘突出症患者行膨胀性椎间融合器植入融合术。术前进行心理护理及体位训练,术后早期指导康复锻炼,行高强度的腰背肌锻炼,讲授出院后的注意事项。采用日本矫形外科协会(JOA)下腰痛评分标准及VAS(视觉模拟评分法)评分评价。结果术后3例出现脑脊液漏,1例出现患肢麻木、无力加重,经护理干预后痊愈。无感染及融合器脱落移位发生,未出现护理并发症。JO A评分由术前平均(4.5±1.3)分改善为末次随访时的(12.8±3.5)分,平均改善率66.4%,腰腿痛VAS评分由术前平均(3.68±1.8)分下降为末次随访时的(0.78±0.6)分。末次随访椎间植骨均获得融合。结论小切口下应用膨胀性椎间融合器行腰椎融合术治疗复发性腰椎间盘突出症,是一种新型微创的治疗方法,术后可早期腰背肌锻炼;采用早期、高强度的康复锻炼,能有效地促进腰椎融合术后患者的功能恢复,减轻腰背痛,提高疗效。【Objective】 To explore the rehabilitation exercise of expandable intervertebral fusion cage in treatment of recurrent lumbar disc herniation with small incision. 【Methods】 From May 2012 to Dec. 2013,42 patients of recurrent lumbar disc herniation received expandable intervertebral fusion cage implantation.Psychological nursing and posture training were conducted preoperatively. After operation, early rehabilitation exercise and high strength back muscle exercise were guided, post-discharge cautions were told. Japanese Orthopedic Association（JOA） scoring standards and VAS low back pain（visual analogue scale） score were used. 【Results】 Cerebrospinal fluid leakage occurred in 3 cases after operation, 1 cases had limb numbness and weakness aggravation. There was no infection or cage displacement or complication. JOA score improved from（4.5 ± 1.3） points preoperatively to（12.8 ± 3.5） points at the last follow-up with the average improvement rate of 66.4%. Low back pain VAS score dropped from preoperative average（3.68 ± 1.8） points to（0.78 ±0. 6） points at the last follow-up. At the end of the follow-up, the fusion of bone graft was obtained.【Conclusions】 Expandable lumbar interbody fusion for the treatment of recurrent lumbar disc herniation with small incision is a new minimally invasive treatment method. Back muscle exercise can be carried out early after operation. Early and high-intensity rehabilitation training can effectively promote the minimally invasive lumbar interbody fusion after functional recovery, relieve back pain and improve curative effect.

关 键 词：脊柱融合术 护理 腰椎间盘突出症 复发性 微创性 

分 类 号：R687[医药卫生—骨科学]