椎间非融合椎弓根动态固定系统治疗腰椎间盘突出症短期临床疗效  

The short-term clinical effect of the treatment of lumbar disc herniation with the dynamic fixation system of intervertebral non-fusion pedicle

作　　者：孙建广[1] 皮国富[1] 韩钰[1] 黄世磊[1] 罗成汉[1] 李峰[1] Sun Jianguang;Pi Guofu;Han Yu;Huang Shilei;Luo Chenghan;Li feng(Department Orthopaedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院骨科,450002

出　　处：《中华实验外科杂志》2020年第5期954-956,共3页Chinese Journal of Experimental Surgery

摘　　要：目的:探讨椎间非融合椎弓根动态(K-Rod)固定系统治疗腰椎间盘突出症的短期临床效果。方法:收集郑州大学第一附属医院2009年5月至2016年5月间因腰椎间盘突出症接受腰椎椎间非融合K-Rod固定系统治疗的患者79例,其中男51例,女28例,年龄范围为18~63岁,平均年龄40岁。手术节段:单节段59例(L 2~L 3 1例、L 3~L 4 4例、L 4~L 5 28例、L 5~S 1 26例)、双节段20例(L 4~S 1 15例、L 3~L 5 4例、L 2~L 4 1例)。随访时间12~36个月。平均随访时间20个月,随访期记录术前、术后所有患者日本骨科协会(JOA)评分、JOA改善率、Oswestry功能障碍指数(ODI)评分、视觉模拟评分法(VAS)评分及相关的手术并发症,按手术节段、年龄、减压方式分组对比术前及末次随访结果并计算改善率,评价手术疗效。采用t检验对术前及术后评分进行统计学分析,以双侧检验 P<0.05为差异有统计学意义。 结果:所有患者腰腿疼痛症状较术前明显改善,生活质量明显改善。79例患者末次随访JOA评分[(27.1±1.3)分]、ODI评分[(8.7±2.9)分]、VAS评分[(1.3±4.8)分]都较术前JOA评分[(11.6±3.8)分]、ODI评分[(44.1±12.9)分]、VAS评分[(7.7±0.66)分]有明显改善(JOA: t=-40.540;ODI: t=23.810;VAS: t=71.420, P<0.05)。在分组研究中可见手术节段数量与减压方式对手术疗效无明显影响( t=1.520, P>0.05),而L 4~L 5较L 5~S 1手术效果改善更加明显( t=2.780, P<0.05),年轻患者较老年患者手术效果更满意( t=2.070, P<0.05)。 结论:椎间非融合K-Rod固定系统治疗腰椎间盘突出症近期临床疗效满意,针对L 4~L 5间隙的疗效更加显著。Objective To explore the short-term clinical effect of dynamic pedicle fixation system without interbody fusion(k-rod fixation)in the treatment of lumbar disc herniation.Methods 79 patients(51 males and 28 females),age(18 to 63 years),the average age of 40 years,who underwent lumbar discectomy with interbody non-fusion K-Rod fixation system for lumbar disc herniation in the First Affiliated Hospital of Zhengzhou University between May 2009 to May 2014.Surgical segments:single segment 59 cases(L2-L31 case,L3-L44 cases,L4-L528 cases,L5-S126 cases),20 cases of double segments(L4-S115 cases,L3-L54 cases,L2-L41 case).12 to 36 months follow-up period,the average follow-up time is 20 months.Recording the postoperative JOA score,JOA improvement rate,ODI score,VAS scores and related complications during the follow-up period,and compare the results of last follow-up to the preoperative to evaluate the surgery.The JOA improvement rates were calculated according to the surgical segments,ages,and decompression methods to evaluate the surgery.The test was used for statistical analysis of the preoperative and postoperative scores,and the two-sided test P<0.05 was considered statistically significant.Results All patients preoperative leg pain symptoms are significantly improved,life quality improved significantly.79 patients last follow-up JOA score(27.1±1.3),ODI score(8.7±2.9),VAS score(1.3±4.8)were compared with preoperative JOA score(11.6±3.8),ODI score(44.1±12.9),VAS score(7.7±0.66)significantly improved(JOA:t=-40.540;ODI:t=23.810;VAS:t=71.420,P<0.05).Groups study found that the length of constructs exerts no significant effect(t=1.520,P>0.05)on surgery result,L4-L5 group showed a relatively better surgical results over the L5-S1 group(t=2.780,P<0.05),younger patients’surgical results are more satisfied than older patients(t=2.07,P<0.05).Conclusion Discetomy with non-fusion K-Rod fixation system for treatment of lumbar disc herniation short-term clinical results were satisfactory,and more significant for the effect o

关 键 词：非融合 椎弓根动态固定系统 腰椎间盘突出症 

分 类 号：R687.3[医药卫生—骨科学]