单侧椎弓根螺钉联合单椎间融合器椎间植骨融合术治疗老年腰椎间盘突出症患者的临床疗效  

Clinical efficacy of unilateral pedicle screw combined with single cage interbody fusion in the treatment of elderly patients with lumbar disc herniation

作　　者：陈伟 黄明光 殷海东 冯杰荣 沈焕武 CHEN Wei, HUANG Ming-guang ,YIN Hai-dong, FENG Jie-rong ,SHEN Huan-wu

机构地区：[1]南方医科大学顺德医院,广东佛山528300

出　　处：《中国药物经济学》2018年第7期30-34,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨单侧椎弓根螺钉联合单椎间融合器(Cage)椎间融合术治疗老年腰椎间盘突出症患者的临床疗效。方法回顾性分析2013年6月至2015年12月顺德医院采用单侧椎弓根螺钉联合单Cage椎间植骨融合术治疗的老年腰椎间盘突出症患者30例,采用日本骨科学会(JOA)下腰痛评分系统评估临床疗效,根据Suk标准评估椎间融合情况。结果所有患者均顺利完成手术,术后进行12~24个月有效随访,平均(16.9±4.1)个月,无螺钉松动、断裂、失效等并发症发生,2例女性患者在术后3个月内出现轻度Cage下沉、椎间隙高度下降。术前JOA评分6~14分,平均(9.9±2.4)分,术后12个月为20~28分,平均(25.3±1.9)分,与术前比较差异有统计学意义(P<0.05),JOA改善总优良率为93.3%,椎间融合率为96.7%。结论单侧椎弓根螺钉联合单Cage椎间融合术治疗老年腰椎间盘突出症具有疗效显著、创伤小、出血少、手术时间短等优点,但应充分考虑到老年腰椎间盘突出症的复杂性及老年患者自身疾病的多样性,重视围术期处理,严格把握其手术适应证与禁忌证。Objective To investigate the clinical outcomes of unilateral pedicle screw combined with single Cage lumbar interbody fusion for the treatment of senile lumbar disc herniation.Methods A retrospective analysis was made of 30 elderly patients with lumbar intervertebral disc herniation treated by unilateral pedicle screw and single Cage interbody fusion in Shunde hospital from June 2013 to December 2015. The clinical efficacy was evaluated by the Japanese Department of orthopedics lower back pain score system and the intervertebral fusion was evaluated according to the Suk standard.Results All patients were successfully completed surgery and followed up 12 to 24 months after operation,average 16.9±4.1 months. All the patients had no screw loosening,fracture and failure, but 2 cases of female patients had mild Cage sinking and intervertebral height decline within 3 months after surgery. Compared with preoperative, JOA score had significant difference（P〈0.05）at different periods after operation from 6± 14 points, average 9.9± 2.4 points, up to 20 ±28 points,an average of 25.3±1.9 points after 12 months, which that fine rate was 93.3%, and the fusion rate was 96.7%.Conclusion The unilateral pedicle screws combined with single Cage lumbar interbody fusion for the treatment of senile lumbar disc herniation with satisfied effect, has the advantages of small trauma, less bleeding and shorter operation time. But, according to the complexity of senile lumbar intervertebral disc protrusion and the diversity of elderly patients with underlying diseases, we should pay attention to perioperative management, strictly grasp the surgical indications and contraindications.

关 键 词：老年人 腰椎间盘突出症 单侧 椎弓根螺钉 椎间融合器 

分 类 号：R687.3[医药卫生—骨科学]