经椎弓根动态固定术与经椎间孔椎间融合术治疗单节段腰椎间盘突出症的临床疗效比较  

Comparison of clinical efficacy of transpedicle dynamic fixation and transforaminal interbody fusion in the treatment of single-segment lumbar disc herniation

作　　者：马验 赵俊豪 高海聪 MA Yan;ZHAO Jun-hao;GAO Hai-cong(Department of Spine Surgery,People's Hospital of Tongchuan,Tongchuan Shaanxi 727031,China)

机构地区：[1]铜川市人民医院脊柱外科,陕西铜川727031

出　　处：《临床和实验医学杂志》2024年第23期2526-2530,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省重点研发计划项目(编号:2023-YBSF-061)。

摘　　要：目的研究单节段腰椎间盘突出症治疗中经椎弓根动态固定术与经椎间孔椎间融合术的疗效。方法回顾性选取2023年1月至2024年3月铜川市人民医院收治入院的100例单节段腰椎间盘突出症患者,按照手术方式不同分为研究组(n=50)与对照组(n=50)。研究组行经椎弓根动态固定术治疗,对照组行经椎间孔椎间融合术治疗。比较两组患者手术相关指标(手术出血量、手术时间、术后下地时间),手术前及手术后1年的手术节段椎间隙高度、腰椎活动度(头侧第一邻近节段活动度、腰椎手术节段活动度、腰椎整体活动度)、Oswestry功能障碍指数(ODI)、腰腿疼痛[视觉模拟评分法(VAS)评分],临床疗效以及并发症发生情况。结果研究组的出血量为(152.03±51.15)mL,低于对照组[(198.36±75.14)mL],手术时间及术后下地时间分别为(160.14±36.42)min、(3.28±0.51)d,均短于对照组[(178.36±38.13)min、(3.92±0.54)d],差异均有统计学意义(P<0.05)。手术后1年,研究组术后手术节段椎间隙高度较术前更低,对照组患者术后腰椎手术节段活动度较术前更高,且研究组患者的手术节段椎间隙高度为(10.01±1.97)mm,明显低于对照组[(11.91±1.68)mm],差异均有统计学意义(P<0.05)。手术后1年,两组患者头侧第一邻近节段活动度、腰椎整体活动度均较手术前明显升高,手术节段活动度均较手术前明显降低,差异均有统计学意义(P<0.05);研究组手术后1年的头侧第一邻近节段活动度为(8.91±2.84)°,低于对照组[(10.22±3.06)°],手术节段活动度为(4.38±0.91)°,高于对照组[(1.42±0.61)°],差异均有统计学意义(P<0.05);两组手术后1年的腰椎整体活动度比较,差异无统计学意义(P>0.05)。手术后1年,两组患者的ODI均较手术前明显降低,差异均有统计学意义(P<0.05);两组患者手术后1年的ODI比较,差异无统计学意义(P>0.05)。手术后1年,两组腰痛、腿痛VAS评分均较手术前明显�Objective To study the efficacy of transpedicle dynamic fixation and transforaminal interbody fusion in the treatment of single-segment lumbar disc herniation.Methods A total of 100 patients with single-segment lumbar disc herniation admitted to People's Hospital of Tongchuan from January 2023 to March 2024 were retrospectively selected and divided into the study group(n=50)and the control group(n=50)according to different surgical methods.The study group was treated by transpedicle dynamic fixation and the control group was treated by transforaminal interbody fusion.The operation related indexes(operation bleeding volume,operation time,postoperative ambulation time),the height of intervertebral space of the surgical segment,the range of motion of the lumbar spine(the range of motion of the first adjacent segment of the head side,the range of motion of the lumbar surgical segment,the overall range of motion of the lumbar spine),the Oswestry disability index(ODI),the lumbar and leg pain[visual analogue scale(VAS)score]before operation and 1 year after operation,clinical efficacy and complications were compared between the two groups.Results The amount of bleeding in the study group was(152.03±51.15)mL,which was lower than that in the control group[(198.36±75.14)mL],the operation time and postoperative ambulation time were(160.14±36.42)min and(3.28±0.51)d,respectively,which were shorter than those in the control group[(178.36±38.13)min and(3.92±0.54)d],and the differences were statistically significant(P<0.05).At 1 year after operation,the intervertebral space height of the surgical segment in the study group was lower than that before operation,and the range of motion of the lumbar surgical segment in the control group was higher than that before operation,the intervertebral space height of the surgical segment in the study group was(10.01±1.97)mm,which was significantly lower than that in the control group[(11.91±1.68)mm],and the differences were statistically significant(P<0.05).At 1 year after operation

关 键 词：腰椎 单节段腰椎间盘突出症 经椎弓根动态固定术 经椎间孔椎间融合术 疗效 

分 类 号：R68[医药卫生—骨科学]