单侧椎弓根螺钉联合椎间融合术治疗单节段腰椎间盘突出伴椎体不稳的临床疗效  

Clinical Effect of Unilateral Pedicle Screw Fixation Combined with Interbody Fusion in Single-segment Lumbar Disc Herniation with Lumbar Instability

作　　者：张姚 葛行新 李华 魏东 曹贞国 ZHANG Yao;GE Xing-xin;LI Hua(Department of orthopedics,the second affiliated hospital of Xuzhou medical university,Xuzhou Jiangsu 221000)

机构地区：[1]徐州医科大学第二附属医院-徐州矿务集团总医院骨科,江苏徐州221000

出　　处：《中国伤残医学》2022年第15期1-5,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：评价单侧与双侧椎弓根螺钉联合椎间融合术(PLIF)治疗单节段腰椎间盘突出伴椎体不稳的临床疗效.方法:回顾性分析2018年1月-2020年1月我院治疗的60例应用椎弓根钉内固定联合椎间融合术治疗单节段腰椎间盘突出伴椎体不稳的患者分为2组,单侧椎弓根钉组30例(单侧组)、双侧椎弓根钉组30例(双侧组).比较2组间手术时间、围术期失血量(术中失血量及术后引流量)、住院时间,术后临床疗效(VAS及ODI评分)、椎体间融合率及术后并发症.结果:单侧组手术时间、围术期出血量明显低于双侧组(P<0.05),但住院时间2组无统计学差异(P>0.05).本组随访观察12-24个月(平均17.7个月).2组间术前VAS及ODI评分无统计学意义(P>0.05) ,术后2 组间VAS及ODI评分与术前相比均显著降低(P<0.05),虽然术后1周VAS及ODI评分2组间差异有统计学意义(P<0.05),但是术后1、3、6个月的临床疗效(VAS及ODI评分)2组间差异无统计学意义(P>0.05),2组间椎间融合率无统计学意义(P>0.05).结论:单侧或双侧椎弓根螺钉固定联合椎间融合术(PLIF)治疗单节段腰椎间盘突出伴椎体不稳都有满意的临床疗效.与双侧组相比,单侧组手术时间短、椎旁肌损伤小、围术期出血量少,早期效果更为满意,加快患者术后腰腿痛症状的早期恢复.Objective:To observe the clinical effect of unilateral and bilateral pedicle screw fixation combined with interbody fusion(PLIF)in single-segment lumbar disc herniation with lumbar instability.Methods:A retrospective analysis of 60 patients treated with pedicle screw fixation combined with interbody fusion for treatment of single-segment lumbar intervertebral disc herniation with lumbar instability treated from January 2018 to January 2020 was divided into two groups,of which unilateral There were 30 cases in pedicle screw fixation group(unilateral group)and 30 cases in bilateral pedicle screw fixation group(bilateral group),The operation time,perioperative blood loss(intraoperative blood loss,postoperative drainage),hospital stay,postoperative clinical efficacy(VAS score,ODI score),intervertebral fusion rate,and postoperative complications were compared between the two groups.Results:The operation time and perioperative bleeding volume in the unilateral group were significantly lower than those in the bilateral group(P<0.05),but there was no significant difference in the length of hospital stay between the two groups(P>0.05).This group was folowed up for 12 to 24 months,with an average of 17.7 months.The VAS and ODI scores before surgery were not statistically significant between the two groups(P>0.05),and the VAS scores and ODI scores between the two groups were significantly lower than before surgery(P<0.05).Although the dfference in ODI and VAS score between the two groups was statistically significant at one week after surgery(P<0.05),there was no significant difference in the clinical efficacy(VAS score,ODI score)at 1,3,and 6 months after surgery(P>0.05).The intervertebral fusion rate between the two groups was not statistically significant(P>0.05).Conclusion:Unilateral or bilateral pedicle screw fixation combined with interbody fusion interbody fusion(PLIF)for single-segment lumbar disc herniation with lumbar instability have satisfactory clinical effects.Compared with the bilateral group,the unilateral gr

关 键 词：单侧椎弓根螺钉 椎间融合术 腰椎间盘突出症 椎体不稳 

分 类 号：R681.5[医药卫生—骨科学]