| 单侧椎弓根螺钉内固定治疗极外侧型腰椎间盘突出症 |
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投稿时间：2012-01-09
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| 作者 | Author | 单位 | Address | E-Mail |
| 夏友敬 |
XIA You-jing |
安化县人民医院骨科,湖南 安化 413500 |
Department of Orthopaedics,People's Hospital of Anhua County,Anhua 413500,Hunan,China |
xyj7577@tom.com |
| 肖志勤 |
XIAO Zhi-qin |
安化县人民医院骨科,湖南 安化 413500 |
Department of Orthopaedics,People's Hospital of Anhua County,Anhua 413500,Hunan,China |
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| 黄攀 |
HUANG Pan |
安化县人民医院骨科,湖南 安化 413500 |
Department of Orthopaedics,People's Hospital of Anhua County,Anhua 413500,Hunan,China |
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| 期刊信息：《中国骨伤》2012年，第25卷，第6期，第455-458页 |
| DOI：10.3969/j.issn.1003-0034.2012.06.004 |
| 基金项目: |
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中文摘要:
目的: 探讨腰椎单侧椎弓根螺钉内固定治疗极外侧型腰椎间盘突出症的疗效.
方法: 自2007年6月至2009年6月,采用经椎板及关节突切除、单侧固定椎间植骨融合手术治疗极外侧型腰椎间盘突出症25例,男12例,女13例；年龄37～68岁,平均54.6岁；病程3～36个月,平均8.8个月.25例患者均有单侧下肢前侧或(和)后侧、臀部或疼痛或(和)麻木或(和)酸胀感,肌力、感觉及腱反射有不同程度的减退.腰椎CT或MRI检查均表现为极外侧型腰椎间盘突出.手术前后根据日本矫形外科学会(JOA)腰痛评分29分法(包括主观症状、客观体征、膀胱功能)对神经功能进行评分,并根据ODI功能障碍指数(Oswestry disability index,ODI)评分,评价患者的腰椎功能改善情况.
结果: 25例患者均获得随访,时间12～36个月,平均24个月.术后患者伤口均愈合良好,无围手术期及随访期并发症发生.所有患者的神经功能均有不同程度的恢复,末次随访时JOA评分与术前比较有统计学差异(P<0.01),按JOA评分计算的综合平均改善率为94.3%,末次随访时的ODI评分比术前有明显降低(P<0.01).所有患者最终均获得了良好的骨性融合,无复发病例.
结论: 采用经椎板及关节突切除途径、单侧固定椎间植骨融合手术治疗极外侧型腰椎间盘突出症,增加了融合节段的即刻稳定性,恢复和维持椎间高度,取得了高综合改善率和高融合率的双重效果.该术式安全、有效、可靠,但需要严格掌握手术指征. |
| 【关键词】椎间盘移位 外科手术 脊柱融合术 |
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| Treatment of far lateral lumbar disc herniation with unilateral pedicle screw fixation and intervertebral body fusion after decompression |
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ABSTRACT
Objective: To investigate the surgical outcomes of unilateral lumbar pedicle screw fixation and intervertebral body fusion in treating far lateral lumber disc herniation.
Methods: From June 2007 to June 2009,25 patients with far lateral lumbar disc herniation were treated with unilateral lumbar pedicle screw fixation and intervertebral body fusion. There were 12 males and 13 females,which ranged in age from 37 to 68,with an average of 54.6 years. The course of disease was from 3 to 36 months with an average of 8.8 months. All the patients had pain and/or numbness and/or soreness in front and/or the back of unilateral leg and buttocks;muscle strength,sensation and tendon reflexes had declined of different degrees. Lumbar CT or MRI showed far lateral lumbar disc herniation. Neurological function and lumbar function were respectively evaluated according to JOA 29 score system (including subjective,objective symptom and bladder function) and Oswestry disability index (ODI).
Results: All the patients were followed-up from 12 to 36 months with an average of 24 months. Postoperative wound healed well and no perioperative complications and follow-up complications were found. Neurological function of patients obtain recovery of difference degrees.At final follow-up,JOA score and ODI improved compared with that of preoperative data(P<0.01); the mean improvement rate of JOA score was 94.3%. All patients got good bone fusion and no recurrence cases were found.
Conclusion: Unilateral lumbar pedicle screw fixation and intervertebral body fusion could increase the initial stability after fusion,restore and maintain the intervertebral height,and elevate the improvement rate in treating far lateral lumber disc herniation. The surgical method is safe,effective and reliable,but need to strictly control indications. |
| KEY WORDS Intervertebral disk displacement Surgical procedures,operative Spinal fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 夏友敬,肖志勤,黄攀.单侧椎弓根螺钉内固定治疗极外侧型腰椎间盘突出症[J].中国骨伤,2012,25(6):455~458 |
| 英文格式: | XIA You-jing,XIAO Zhi-qin,HUANG Pan.Treatment of far lateral lumbar disc herniation with unilateral pedicle screw fixation and intervertebral body fusion after decompression[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(6):455~458 |
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