腰间盘髓核摘除术联合单侧弹性棒弹性固定治疗腰椎间盘突出症的疗效  

The effect of lumbaRdisc nucleus pulposus excision combined with unilateral elastic rod elastic fixation in the treatment of lumbaRdisc herniation

作　　者：林慰光[1] 胡奕山[1] 姚迦勒[1] 郑干轩[1] 罗勤瑜[1] 林本丹[1] LIN Wei-guang;HU Yi-shan;YAO Jia-le;ZHENG Gan-xuan;LUO Qin-yu;LIN Ben-dan(SectionⅠ,Dept of Orthopaedic Surgery,Shantou Central Hospital,Shantou,Guangdong 515031,China)

机构地区：[1]汕头市中心医院骨外一科,广东汕头515031

出　　处：《临床骨科杂志》2022年第4期464-467,共4页Journal of Clinical Orthopaedics

基　　金：广东省科技厅科技创新战略专项资金(纵向协同管理方向)项目(汕府科〔2018〕157号-29)。

摘　　要：目的探讨腰间盘髓核摘除术联合单侧弹性棒弹性固定治疗腰椎间盘突出症的临床效果。方法将72例接受手术治疗的腰椎间盘突出症患者根据治疗方法不同分为观察组(采用腰间盘髓核摘除术联合单侧弹性棒弹性固定,7例)、对照A组(采用传统髓核摘除术,30例)、对照B组(采用孔镜或椎板镜下髓核摘除术,12例)和对照C组(采用椎间盘切除椎间植骨融合钉棒内固定术,23例)。比较手术前后JOA评分以及术后并发症发生情况。结果患者均获得随访,时间1~2年。术后3个月JOA评分:4组均高于术前(P<0.05),观察组均高于对照A、B、C组(P<0.05)。观察组未出现切口感染,术后随访期间X线片显示椎弓根螺钉位置良好且无腰椎不稳,MRI提示神经根无明显受压,且邻近节段无明显椎间盘突出病变;对照A组出现1例切口感染;对照B组出现1例出血、1例马尾神经损伤、1例复发;对照C组出现1例神经系统损伤、1例切口感染。结论腰间盘髓核摘除术联合单侧弹性棒弹性固定治疗腰椎间盘突出症临床效果良好,并发症较少。Objective To investigate the clinical effect of lumbaRdisc nucleus pulposus excision combined with unilateral elastic rod elastic fixation in the treatment of lumbaRdisc herniation.Methods The 72 patients with lumbaRdisc herniation were divided into fouRgroups according to different treatment methods:observation group(lumbaRdisc nucleus pulposus excision combined with unilateral elastic rod elastic fixation,7 cases),control group A(conventional nucleus pulposus excision,30 cases),control group B(excision by pore-scope oRlaminoscope,12 cases)and control group C(lumbaRdisc nucleus pulposus excision combined with intervertebral bone grafting fusion and screw-rod fixation,23 cases).JOA score and postoperative complications were compared before and afteRsurgery.Results All patients were followed up foR1~2 years.JOA scores:at 3 months postoperation,which of fouRgroups were higheRthan those before operation(P<0.05);and the observation group was higheRthan the three control groups(P<0.05).No incision infection occurred in the observation group.At postoperative follow-up,X-ray radiographs showed good pedicle screw position and no lumbaRinstability,MRI showed no obvious nerve root compression,and no obvious disc herniation in adjacent segments.Control group A had 1 case of incision infection.In control group B,there was 1 case of hemorrhage,1 case of cauda equina injury and 1 case of recurrence.Control group C had 1 case of nervous system injury and 1 case of incision infection.Conclusions In the treatment of lumbaRdisc herniation,nucleus pulposus excision combined with unilateral elastic rod elastic fixation has good short-term effect,with feweRcomplications.

关 键 词：腰椎间盘突出症 腰间盘髓核摘除术 单侧弹性棒固定 

分 类 号：R681.57[医药卫生—骨科学] R687.3[医药卫生—外科学]