椎板减压关节突融合联合钉棒系统对单节段腰椎管狭窄症患者脊柱稳定功能的影响  

Effect of laminectomy and facet joint fusion combined with screw-rod system on spinal function stability in patients with single-segment lumbar spinal stenosis

作　　者：雷宜松 刘安平[1] 杨俊忠 易莉艳 LEI Yisong;LIU Anping;YANG Junzhong;YI Liyan(Orthopedics Department,Union Jiangnan Hospital,Huazhong University of Science and Technology,the First People's Hospital of Jiangxia District,Wuhan 430200,Hubei,China)

机构地区：[1]华中科技大学协和江南医院武汉市江夏区第一人民医院骨科,湖北省武汉市430200

出　　处：《中南医学科学杂志》2022年第4期564-567,共4页Medical Science Journal of Central South China

摘　　要：目的观察椎板减压关节突融合联合钉棒系统对单节段腰椎管狭窄症患者脊柱稳定功能的影响。方法选取单节段腰椎管狭窄患者78例,其中行后路腰椎椎间融合手术(PLIF)者为对照组,行椎板减压关节突融合联合钉棒系统治疗者为观察组,比较两组手术疗效、脊柱稳定情况和手术并发症发生情况。结果观察组手术时间、术中出血量、引流量、卧床时间、住院时间均低于对照组(P<0.05)。两组术后3天、6个月、12个月腰痛视觉模拟评分(VAS)、腿痛VAS评分较术前下降(P<0.05),观察组术后3天、3个月腰痛VAS评分低于对照组(P<0.05)。两组术后3个月、6个月、12个月日本骨科协会治疗评估分数(JOA评分)较术前上升(P<0.05),Oswestry功能障碍指数(ODI)较术前下降(P<0.05),而两组间JOA评分、ODI指数比较差异无显著性(P>0.05)。两组患者融合率和并发症发生率比较差异无显著性(P>0.05)。结论椎板减压关节突融合联合钉棒系统治疗腰椎管狭窄具有较好的临床疗效,保持脊柱功能的稳定性,具有组织创伤小,融合率高等优点。Aim To observe effect of laminectomy and facet joint fusion combined with screw-rod system on spinal function stability in patients with single-segment lumbar spinal stenosis.Methods A total of 78 patients with single-segment lumbar spinal stenosis were selected.Patients treated with posterior lumbar interbody fusion surgery(PLIF)were included in the control group,and those treated with laminectomy and facet joint fusion combined with screw-rod system were included in the observation group.Surgical results,spinal stability,and the incidence rates of complications were compared between the two groups.Results The operation time,intraoperative blood loss,drainage volume,bed rest time and hospital stay of observation group were shorter/less than those of control group(P<0.05).The Visual Analogue Scale(VAS)scores of low back pain and leg pain in the two groups were significantly lower at 3 days,6 months and 12 months after operation than before operation(P<0.05).The observation group had significantly lower VAS scores of low back pain than the control group at 3 days and 3 months after operation(P<0.05),but the VAS scores of leg pain showed no significant difference between the two groups at each time point(P>0.05).The Japanese Orthopaedic Association(JOA)scores of the two groups were significantly higher,and the Oswestry disability index(ODI)was significantly lower at 3 months,6 months and 12 months after operation than before operation(P<0.05).However,there was no significant difference in JOA score or ODI between the two groups at each time point(P>0.05).There was no significant difference between the two groups in fusion rate or the incidence of surgical complications(P>0.05).Conclusion Laminectomy and facet joint fusion combined with screw-rod system is effective in the treatment of lumbar spinal stenosis,which can maintain the stability of spinal function,with advantages of little tissue trauma and high fusion rate.

关 键 词：椎板减压关节突融合 钉棒系统 单节段腰椎管狭窄症 脊柱稳定功能 

分 类 号：R68[医药卫生—骨科学]