单侧椎弓根钉内固定结合椎间融合术治疗腰椎间盘突出症疗效剖析.docVIP

单侧椎弓根钉内固定结合椎间融合术治疗腰椎间盘突出症疗效剖析 　　[摘要] 目的：探讨单侧椎弓根钉内固定结合椎间融合术治疗腰椎间盘突出症的临床疗效及优势。方法：在2006年3月~2009年2月期间对52例腰椎间盘突出症的患者采用了内固定椎间融合器治疗，其中单侧椎弓根固定组24例，双侧椎弓根固定组28例。比较两种手术患者手术前后日本骨科协会评分（Japanese Orthopaedic Association，JOA）及腰痛指数（Oswestry disability index，ODI）、手术时间、术中出血量、术后住院天数、住院费用、融合率的情况。结果：术后随访12~20个月（平均16个月），两组患者术前JOA和ODI评分比较差异无统计学意义（P＞0.05），末次随访时的JOA及ODI评分、融合率的差异也无统计学意义（P＞0.05）。所有患者术后的功能参数均优于术前。单侧椎弓根固定组在手术时间、出血量、住院费用方面优于双侧椎弓根固定组（P＜0.01）。结论：单侧椎弓根钉内固定结合椎间融合术治疗腰椎间盘突出症能够取得同双侧椎弓根钉内固定相同的手术效果，而且能够减少手术创伤，适于在临床应用。 　　[关键词] 腰椎间盘突出症；单侧；椎间融合术 　　[中图分类号] R681.5 [文献标识码] Ａ [文章编号] 1673-7210（2012）01（a）-047-03 　　 　　Effects of lumbar interbody fusion combined with unilateral pedicle screw fixation on lumbar disc herniation 　　ZHOU Lianjun, LIU Yan, LI Haiyan 　　Department of Orthopaedics, Duodao People′s Hospital of Jingmen City, Hubei Province, Jingmen 448124, China 　　[Abstract] Objective: To investigate the clinical effects of internal fixation with unilateral pedicle screws combined with intervertebral fusion in lumbar disc herniation. Methods: From march 2006 to February 2009, 52 patients with disc herniation were treated by internal fixation and intervertebral fusion device, there was 24 cases in internal fixation with unilateral radix arcus vertebrae group and 28 cases in fixation with bilateral radix arcus vertebrae group. Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI) scores, operation time, blood loss, hospital days, cost of hospitalization, fusion rate were compared between the two groups. Results: All patients were followed up from 12 to 20 months (average was 16 months). There was no significant difference of the preoperative JOA and ODI scores between the two groups (P＞0.05); in the last follow-up visiting, there was no significant difference of fusion rate, JOA and ODI scores between the two groups (P＞0.05). The postoperative data of all patients were significantly better than those before surgery. The operation time, blood loss and cost of h