单侧椎弓根钉内固定治疗极外侧型腰椎间盘突出症的临床视察.pdfVIP

提 要 目的：极外侧型腰椎间盘突出症（FLLDH ），行髓核摘除椎体间植骨融合或 Cage 植骨融合合并单侧椎弓根钉棒系统内固定治疗，观察临床疗效。 方法：选自 2009 年 10 月至 2011 年 10 月山东中医药大学第二附属医院诊治的 20 例 FLLDH 病例进行分析，男11例，女9例；年龄36—72岁，平均年龄为42.6 岁； 椎间孔型 12 例，椎间孔外型 9 例，分析其临床表现及影像学资料，椎间孔型给予经 后正中椎板间隙入路髓核摘除单边椎弓根钉内固定椎间隙植骨融合术，椎间孔外型给 予经旁正中入路髓核摘除单边椎弓根钉内固定椎间隙植骨融合术，对患者的术前及术 后进行 VAS 评分、JOA 评分、统计学分析。 结果：经过对患者3、6、12、18 个月的随访，经统计，术前的 VAS 评分由 8.50 ±0.51，降低至术后的 0.75 ±0.41，JOA 评分由术前的 9.45 ±1.669 上升至术后的 25.00 ±1.747。 结论：极外侧腰椎间盘突出症椎间孔型及椎间孔外型分别行后正中入路和旁正中 入路髓核摘除单边椎弓根内固定椎间隙植骨融合术，疗效满意。 关键词 极外侧型腰椎间盘突出 ；单侧椎弓根钉棒系统 Unilateral pedicle screw system fixation for the treatment of far lateral lumbar disc herniation observed Speciality：Orthopedics of TCM Author ：Liu Jijian Tutor：Prof. Dong Jianwen Abstract Objective: The extreme lateral disc herniation, conservative treatment fails, the line discectomy and fusion (or fusion cage) unilateral pedicle screw fixation for the treatment, observation and treatment results. Methods: From September 2009 to September 2010 20 patients were treated with complete clinical data of extreme lateral lumbar disc herniation were retrospectively analyzed, 11 males and 9 females; aged 37-71 years, mean 42.5 years; review of relevant literature, summarizes the clinical and imaging findings, preoperative and postoperative VAS score, JOA score compared and analyzed statistically. Results: 20 patients were followed up by 3,6,12,18 months, VAS score improved from the 8.85 ± 0.993, reduced to postoperative 0.90 ± 0.718, JOA score improved from 10.03 ± 2.452 to rise before the postoperative 25.20 ± 2.726. Conclusion: Unilateral pedicle screw fixation, decompression and fusion surgery form a triangular three-dimensional support, cons