经椎间孔椎体间融合术与后路开窗椎间盘髓核摘除术治疗伴终板ModicⅡ型改变腰椎间盘突出症的价值  

The Value of Transforaminal Interbody Fusion and Posterior Fenestration of Nucleus Pulposus in the Treatment of Lumbar Disc Herniation with ModicⅡEndplate Changes

作　　者：李欣 王旭东 LI Xin;WANG Xu-dong(Department of Orthopedics,Changge Second People's Hospital,Xuchang 461500 China)

机构地区：[1]长葛市第二人民医院骨科,河南长葛461500

出　　处：《内蒙古医学杂志》2022年第1期12-14,F0002,共4页Inner Mongolia Medical Journal

基　　金：河南省自然科学基金项目(编号:LHGJ2017001139)。

摘　　要：目的探讨经椎间孔椎体间融合术与后路开窗椎间盘髓核摘除术治疗伴终板ModicⅡ型改变腰椎间盘突出症的价值。方法回顾性选取2018年12月至2020年12月在本院确诊的86例伴终板ModicⅡ型改变腰椎间盘突出症患者,根据手术方式的不同分为经椎间孔椎体间融合术组(TLIF组)(46例)和后路开窗椎间盘髓核摘除术组(MED组)(40例)。收集比较两组患者的围手术期相关指标、术后6个月的Macnab疗效的评估结果以及术前、术后6月的腰椎ODI和腰腿疼痛程度(VAS)评分结果。结果TLIF组治疗的优良率为76.09%,高于MED组的55.00%(χ^(2)=4.257,P=0.039);TLIF组的手术时间、术中出血量、切口长度,住院时间均小于MED组(P<0.05);术后6月,TLIF组的ODI以及VAS评分小于MED组(P<0.05)。结论经椎间孔椎体间融合术治疗伴终板ModicⅡ型改变腰椎间盘突出症的疗效较好。Objective To investigate the value of transforaminal interbody fusion and posterior fenestration of the nucleus pulposus in the treatment of lumbar disc herniation with ModicⅡendplate changes.Methods A retrospective selection of 86 patients with lumbar disc herniation with Modic type II endplate changes diagnosed in our hospital from December 2019 to December 2021 were retrospectively selected and divided into the transforaminal interbody fusion group according to the different surgical methods(TLIF group)(46 cases)and posterior fenestration disc nucleus pulposus group(MED group)(40 cases).The perioperative indicators of the two groups of patients were collected and compared,the evaluation results of Macnab efficacy at 6 months after the operation,and the lumbar ODI and waist and leg pain(VAS)scores before and 6 months after the operation were collected and compared.Results The excellent and good rate of treatment in the TLIF group was 76.09%,which was higher than 55.00%in the MED group(χ^(2)=4.257,P=0.039);the operation time,intraoperative blood loss,incision length,and hospital stay of the TLIF group were all shorter than those of the MED group(P<0.05);6 months after the operation,the ODI and VAS scores of the TLIF group were lower than those of the MED group(P<0.05).Conclusion Transforaminal interbody fusion is effective in treating lumbar disc herniation with ModicⅡendplate changes.

关 键 词：经椎间孔椎体间融合术 后路开窗椎间盘髓核摘除术 ModicⅡ型改变 腰椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学]