腰椎间盘突出摘除融合钉棒固定治疗腰椎间盘突出伴腰椎不稳症的疗效  

Analysis of efficacy and complications of lumbar disc herniation with lumbar instability treated by lumbar disc herniation removal

作　　者：马祖宁 李要争 章鑫 陈国豪 MA Zu-ning;LI Yao-zheng;ZHANG Xin;CHEN Guo-hao(Department of Orthopedics,Huangshan Shoukang Hospital,Huangshan 245000,Anhui,China)

机构地区：[1]黄山首康医院骨科,安徽黄山245000

出　　处：《川北医学院学报》2024年第2期173-176,193,共5页Journal of North Sichuan Medical College

基　　金：安徽首科技攻关计划项目(1704f0804018)。

摘　　要：目的:探讨腰椎间盘突出摘除融合钉棒固定治疗腰椎间盘突出(LDH)伴腰椎不稳症的疗效。方法:按照治疗方法不同将116例LDH伴腰椎不稳症患者分为对照组(n=51)和实验组(n=65)。对照组行传统腰椎间盘摘除术;实验组行腰椎间盘突出摘除融合钉棒固定术。比较两组患者手术情况及日本骨科协会(JOA)下腰痛手术评分、融合节段椎间隙高度、腰椎影像学参数(椎间盘腹侧高度、椎间盘背侧高度、椎间孔间最大高度、棘突顶距)、术后并发症发生情况及植骨融合率。结果:实验组术后下床活动时间早于对照组(P<0.05)。术后3、6、12个月,实验组JOA评分及椎间隙高度均高于对照组(P<0.05);实验组术后3、12个月的腰椎影像学参数均优于对照组(P<0.05);并发症发生率小于对照组(P<0.05);实验组术后3、6、12个月的植骨融合情况较好73.31%、81.54%、90.77%。结论:腰椎间盘突出摘除融合钉棒固定治疗LDH伴腰椎不稳症的疗效良好,且术后并发症发生率较少。Objective:To explore the efficacy and complications of lumbar disc herniation removal in the treatment of lumbar disc herniation(LDH)with lumbar instability.Methods:Among 116 patients with LDH and lumbar instability,51 cases undergoing traditional lumbar disc removal were selected as control group,and 65 cases who received lumbar disc herniation removal and screw rob fixation were included in trial group.The surgical conditions,Japanese Orthopedic Association(JOA)low back pain score,intervertebral space height of fusion segment,lumbar imaging parameters(ventral disc height,dorsal disc height,maximum interforaminal height,apex distance of spinous process),occurrence of postoperative complications and bone graft fusion rate were compared between the two groups of patients.Results:The early postoperative ambulation time in trial group was earlier than that in control group(P<0.05).The JOA score and intervertebral space height in trial group were higher than those in control group at 3,6,and 12 months after surgery(P<0.05).The lumbar imaging parameters in trial group at 3 and 12 months after surgery were better than those in control group(P<0.05),and the incidence rates of postoperative complications were lower compared with those in control group(P<0.05).The postoperative bone graft fusion was better in trial group,and the bone graft fusion rates at 3,6 and 12 months after surgery were 73.31%,81.54%and 90.77%,respectively.Conclusion:Lumbar disc herniation removal combined with screw rod fixation has good efficacy and low incidence rates of postoperative complications in treating LDH with lumbar instability.

关 键 词：腰椎间盘突出症 腰椎不稳症 钉棒固定 腰椎间盘突出摘除术 疗效 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]