腰椎后路Quadrant通道下髓核摘除术联合减压植骨融合内固定术治疗LDH合并腰椎不稳疗效观察  

Observation on Clinical Efficacy of Posterior Lumbar Discectomy via Quadrant Retractor Combined with Bone Graft Fusion for LDH with Lumbar Instability

作　　者：彭小勇 李挺 丁立林 徐庆刚[2] Peng Xiaoyong;Li Ting;Ding Lilin;Xu Qinggang(Department of Orthopedics,People＇s Hospital of Nancheng,Nancheng 344700 China;The Fifth Surgical Department,the Affiliated Hospital of Jiangxi University ofTraditional Chinese Medicine,Nanchang 330004 China)

机构地区：[1]南城县人民医院骨科,江西南城344700 [2]江西中医药大学附属医院外五科,江西南昌330004

出　　处：《锦州医科大学学报》2018年第4期55-58,共4页Journal of Jinzhou Medical University

摘　　要：目的评价腰椎后路Quadrant通道下髓核摘除术联合减压植骨融合内固定术治疗腰椎间盘突出症(LDH)合并腰椎不稳的临床效果。方法将2014年1月至2016年1月在我院行腰椎后路Quadrant通道下髓核摘除术联合减压植骨融合内固定术治疗的76例LDH合并腰椎不稳患者作为观察组,同期采用传统后正中入路下行腰椎融合术治疗的76例LDH合并腰椎不稳患者作为对照组。比较两组的治疗效果。结果观察组切口长度、术中出血量及住院天数均显著低于对照组(P<0.05);两组VAS、ODI及JOA评分在术后3个月、6个月和1年时均较术前明显改善(P<0.05),而观察组改善幅度更大,与对照组差异显著(P<0.05)。结论腰椎后路Quadrant通道下髓核摘除术联合减压植骨融合内固定术治疗LDH合并腰椎不稳疗效确切,且具有创伤小、术后恢复快等优势,值得推荐。Objective To evaluate the clinical effect of posterior lumbar discectomy via Quadrant retractor combined with bone graft fusion in the treatment of LDH with lumbar instability. Methods 76 patients of LDH with lumbar instability who were treated with posterior lumbar discectomy via Quadrant retractor combined with bone graft fusion in our hospital from January 2014 to January2016 were selected as the observation group. In the same period,76 patients of LDH with lumbar instability who were given traditional posterior median approach for lumbar interbody fusion were selected as the control group. The therapeutic effects of the two groups were compared. Results The length of incision,volume of intraoperative bleeding and length of hospital stay in the observation group were significantly lower than those of the control group（ P〈0. 05）,compared with those before operation,VAS,ODI and JOA scores of the two groups at the end of 3 month,6 month and 1 year after operation were improved significantly（ P〈0. 05）,moreover,the improvement was greater in the observation group,which was statistically different from that in the control group（ P〈0. 05）. Conclusion Posterior lumbar discectomy via Quadrant retractor combined with bone graft fusion for LDH with lumbar instability has the advantages of less trauma and faster postoperative recovery,which is worth recommending.

关 键 词：腰椎间盘突出症 腰椎不稳 外科手术 QUADRANT通道 植骨融合 

分 类 号：R687.3[医药卫生—骨科学]