经后路椎间盘摘除植骨融合内固定术与开窗减压髓核摘除术治疗腰椎间盘突出症对远期疗效的影响  

The Effect on Long-term Outcome of Posterior Transforaminal Disc Removal,Bone Graft Fusion Internal Fixation versus Open Window Decompression Nucleus Pulposus Removal in the Treatment of Lumbar Intervertebral Disc Herniation

作　　者：冯旭 FENG Xu(Department of Orthopedics,Nantong Zhongshan Orthopedic Hospital,Nantong,Jiangsu Province,226001 China)

机构地区：[1]江苏省南通市中山骨科医院骨科,江苏南通226001

出　　处：《中外医疗》2023年第19期100-103,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨经后路椎间盘摘除植骨融合内固定术与开窗减压髓核摘除术治疗腰椎间盘突出症对患者远期疗效的影响。方法 方便选取2020年1月-2022年12月江苏省南通市中山骨科医院收治的122例腰椎间盘突出症患者为研究对象,按照治疗方法分为两组,施以开窗减压髓核摘除术进行治疗的61例为对照组,施以经后路椎间盘摘除植骨融合内固定术进行治疗的61例为观察组,在接受治疗1年后随访分析两组患者的治疗效果。结果 观察组临床疗效为93.44%高于对照组的77.05%,差异有统计学意义(χ^(2)=6.517,P<0.05),对照组的复发率高于观察组,差异有统计学意义(P<0.05);治疗后,观察组承受疼痛程度评分低于对照组,差异有统计学意义(P<0.05);观察组患者手术时间、术中出血量、下床时间均优于对照组,差异有统计学意义(P<0.05)。结论 腰椎间盘突出症患者通过经后路椎间盘摘除植骨融合内固定术治疗相较于开窗减压髓核摘除术,能够最大程度地缓解患者的疼痛感,让患者拥有更为理想的治疗成效,且其复发率低,值得临床推广。Objective To investigate the effects on long-term outcome of lumbar disc herniation treated by posterior disc removal,bone graft fusion internal fixation and open window decompression nucleus pulposus removal.Methods A total of 122 patients with lumbar disc herniation admitted to Zhongshan Orthopaedic Hospital of Nantong City,Jiangsu Province from January 2020 to December 2022 were conveniently selected as the study objects.Divided into two groups according to different treatment methods.61 patients undergoing fenestration decompression nucleus pulposus extraction were selected as the control group,and 61 patients undergoing posterior disc removal and bone grafting fusion internal fixation were selected as the observation group.The effect of treatment was analyzed at 1 year follow-up.Results The clinical effect of observation group was 93.44%higher than that of control group(77.05%),the difference was statistically significant(χ^(2)=6.517,P<0.05).The recurrence rate of control group was higher than that of observation group,the difference was statistically significant(P<0.05).After treatment,the pain degree of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Operation time,intraoperative blood loss and time to get out of bed in observation group were better than those in control group,the difference was statistically significant(P<0.05).Conclusion Compare with open window decompression nucleus pulposus removal,lumbar disc herniation treatment through posterior disc removal and bone graft fusion internal fixation can maximize the relief of patients´pain,so that the patients have more ideal treatment results,and its recurrence rate is low,which is worthy of clinical promotion.

关 键 词：腰椎间盘突出症 经后路椎间盘摘除植骨融合内固定术 开窗减压髓核摘除术 临床效果 

分 类 号：R687.3[医药卫生—骨科学]