弹性棒固定治疗两节腰椎间盘突出症的疗效观察  

The efficacy observation about flexible transpedicle fixation system in treatment of two segment lumbar degenerative diseases

作　　者：卫秀洋[1] 陈勇忠[1] 王金星[1] 黄哲[1] 

机构地区：[1]福州总医院476医院骨科,福建福州350002

出　　处：《临床骨科杂志》2016年第3期306-309,共4页Journal of Clinical Orthopaedics

基　　金：南京军区医学科技创新课题(编号:11MB028)

摘　　要：目的：探讨弹性棒固定治疗两节腰椎间盘突出的疗效，评估其对邻近节段退变的影响。方法将68例两节腰椎间盘突出患者按手术方法不同分为两组：观察组36例采用L3～4、L4～5椎间盘切除减压后弹性棒椎弓根钉固定术；对照组32例采用L3～4、L4～5椎间盘切除、横突植骨、椎弓根钉棒固定术。采用疼痛VAS评分评价临床疗效，通过X线片测量腰椎各间隙高度。结果患者均获得随访，时间15～34（26.2±2.3）个月。VAS评分：两组术后1周、末次随访时与术前比较差异均有统计学意义（P＜0.05），术后1周两组间比较差异无统计学意义（P＞0.05）；末次随访时两组差异有统计学意义（P＜0.05）。末次随访时，上位邻近节段L2～3椎间隙高度两组差异有统计学意义（P＜0.05），L3～4、L4～5节段椎间隙高度两组比较差异无统计学意义（P＞0.05）。结论弹性固定治疗腰椎间盘突出症取得较好的临床疗效，并能降低相邻节段退变的发生。Objective To explore the treatment effects of flexible transpedicle fixation system in two segment lumbar spinal disease , and to evaluate their influence on adjacent segments .Methods A total of 68 cases of lumbar disc herniation（LDH） were treated;36 patients underwent L3-4,L4-5 discectomy elastic rod and pedicle screw fixation system were classified as observation group; 32 patients underwent L3-4,L4-5 discectomy,lumbar fusion, pedicle screw fixation were classified as control group .The clinical effect was evaluated by pain visual analogue scale （ VAS） . The intervertebral height was measured by X-ray film.Results All patients were followed up for 15-34 （26.2 ± 2.3） months.VAS evaluation results：VAS of postoperative one week and the last follow-up was compared with the preoperative,differences were statistically significant （P〈0.05）;postoperation one week, they showed no significant difference between the two groups （ P〉0.05 ）; the difference was statistically significant at last follow-up （ P 〈0.05）.At last follow-up, near the upper segment L2-3 intervertebral height difference was statistically significant be-tween two groups（P〈0.05）.About surgical segment L3-4 and L4-5 intervertebral height,there were no significant difference between the two groups （ P〉0.05 ） .Conclusions Flexible transpedicle fixation system have satisfying effects in treatment of degenerative lumbar spinal disorder .Non-fusion fixation can reduce adjacent segment degenera-tion.

关 键 词：腰椎间盘突出症 弹性固定 坚强固定 椎弓根钉 邻近节段退变 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]