腰椎后路椎间融合术联合单侧与双侧椎弓根固定促进腰椎间盘突出症伴腰椎不稳患者腰椎功能恢复的效果对比  

Comparison of the Effects of Posterior Lumbar Interbody Fusion Combined with Unilateral and Bilateral Pedicle Fixation on Promoting Lumbar Functional Recovery in Patients with Lumbar Disc Herniation and Lumbar Instability

作　　者：邹浩 谢虎 ZOU Hao;XIE Hu(Department of Spine Surgery,Yichang Changhang Hospital,Yichang 443000,China;Department of Spine Surgery,The Second People's Hospital of Yichang City,Yichang 443000,China)

机构地区：[1]宜昌长航医院脊柱外科,湖北宜昌443000 [2]宜昌市第二人民医院脊柱外科,湖北宜昌443000

出　　处：《反射疗法与康复医学》2024年第10期138-140,151,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的比较腰椎后路椎间融合术(PLIF)联合单侧与双侧椎弓根固定对腰椎间盘突出症(LDH)伴腰椎不稳患者的影响。方法选取2020年8月—2023年8月宜昌长航医院收治的74例LDH伴腰椎不稳患者为研究对象,按随机数字表法将其分为对照组和观察组,各37例。对照组行PLIF联合双侧椎弓根固定,观察组行PLIF联合单侧椎弓根固定。对比两组围手术期指标、疼痛程度、脊柱稳定性、腰椎功能、生活质量、并发症发生情况。结果观察组术中出血量少于对照组,手术时间短于对照组,组间差异有统计学意义(P<0.05)。术后3个月,观察组疼痛视觉模拟评分低于对照组,差异有统计学意义(P<0.05);两组Oswestry功能障碍指数与生活质量综合评定问卷各个维度评分相比,组间差异无统计学意义(P>0.05)。两组腰椎前凸角、胸椎后凸角、矢状面平衡相比,组间差异无统计学意义(P﹥0.05)。结论PLIF联合单侧与双侧椎弓根固定均可改善LDH伴腰椎不稳患者腰椎功能,提高脊柱稳定性,提升生活质量,而PLIF联合单侧椎弓根固定存在更小的创伤、更短的术式时间,可有效缓解患者术后疼痛。Objective To compare the effects of posterior lumbar interbody fusion(PLIF)combined with unilateral and bilateral pedicle fixation on patients with lumbar disc herniation(LDH)and lumbar instability.Methods A total of 74 patients with LDH accompanied by lumbar instability admitted to Yichang Changhang Hospital from August 2020 to August 2023 were selected as the research subjects.They were randomly divided into a control group and an observation group,with 37 cases in each group,using a random number table method.The control group received PLIF combined with bilateral pedicle fixation,while the observation group received PLIF combined with unilateral pedicle fixation.Compare perioperative indicators,degree of pain,spinal stability,lumbar spine function,quality of life,and complications between two groups.Results The observation group had less intraoperative bleeding and shorter surgical time than the control group,with statistically significant differences between the groups(P<0.05).3 months after surgery,the Visual Analouge Scale score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05);there were no statistically significant differences in the Oswestry Disability Index,and Quality of Life Comprehensive Evaluation Questionnaire scores between the two groups(P>0.05).There were no significant differences in lumbar lordotic Angle,thoracic kyphotic Angle and sagittal plane balance between the two groups(P﹥0.05).Conclusion PLIF combined with unilateral and bilateral pedicle fixation can improve lumbar function,enhance spinal stability,and enhance quality of life in patients with LDH and lumbar instability.However,PLIF combined with unilateral pedicle fixation has smaller trauma and shorter surgical time, which can effectively alleviate postoperative pain in patients.

关 键 词：腰椎间盘突出症 腰椎不稳 生活质量 并发症 

分 类 号：R684[医药卫生—骨科学]