| 改良腰椎板截骨回植治疗失稳性腰椎间盘突出症 |
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投稿时间：2013-03-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 刘琮 |
LIU Cong |
西安医学院, 陕西 西安 710000 |
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| 徐洪海 |
XU Hong-hai |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
xuhonghai1963@126.com |
| 邹庆洋 |
ZOU Qing-yang |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
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| 郭雄 |
GUO Xiong |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
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| 刘宗智 |
LIU Zong-zhi |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
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| 罗振群 |
LUO Zhen-qun |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
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| 李勇 |
LI Yong |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
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| 祁洁 |
QI Jie |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
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| 刘军 |
LIU Jun |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
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| 任鹏宇 |
REN Peng-yu |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
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| 范亚一 |
FAN Ya-yi |
西安交通大学第三临床学院陕西省人民医院骨科, 陕西 西安 710068 |
Department of Orthopaedics, Shaanxi Provincial People's Hospital, the Third Affiliated Hospital, Xi'an Jiaotong University of Medicine, Xi'an 710068, Shaanxi, China |
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| 期刊信息：《中国骨伤》2013年，第26卷，第11期，第918-922页 |
| DOI：10.3969/j.issn.1003-0034.2013.11.010 |
| 基金项目:陕西省科学技术研究发展计划项目(编号:2011K14-08-02;2001K10-G9);西安市科技计划项目[(编号:HM1121(1)] |
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中文摘要:
目的：评价改良腰椎板截骨回植在失稳性腰椎间盘突出症中的疗效。
方法：2009年3月至2011年8月对63例失稳性腰椎间盘突出症的患者行髓核摘除+椎间融合+椎弓根螺钉内固定+改良腰椎板截骨回植手术，男33例，女30例；年龄22～68岁，平均48.4岁；病程3个月～13年，平均38.8个月。患者均有不同程度的腰腿疼痛，X线片、CT及MR检查诊断为失稳性腰椎间盘突出症。观测手术前后ODI和JOA评分、并发症发生率、影像学回植椎板愈合率及腰腿痛复发率。
结果：62例患者切口Ⅰ期愈合，1例Ⅱ期愈合，无下肢深静脉血栓及椎间隙感染等并发症出现。61例获1年或以上随访，平均随访时间33个月。术中神经损伤发生2例，硬膜囊损伤发生1例；术后1年回植椎板愈合58例；腰痛复发4例，腿痛复发1例。术后2周、6、12个月的ODI及JOA评分显着优于术前（P<0.05）.
结论：改良椎板截骨回植术治疗失稳性腰椎间盘突出症具有较低的术中神经硬膜囊损伤率和腰腿痛复发率、较高的椎板愈合率和较好的临床评分，是一种安全、有效的新方法，为临床失稳性腰椎间盘突出症手术开辟了一种新的术式。 |
| 【关键词】腰椎 椎间盘移位 脊柱融合术 外科手术 |
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| Treatment of unstable lumbar intervertebral disc herniation by modified lamina osteotomy replantation |
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ABSTRACT
Objective: To evaluate the clinical effects of the modified lamina replantation for the treatment of unstable lumbar intervertebral disc herniation.
Methods: From March 2009 to August 2011,63 patients with unstable lumbar intervertebral disc herniation were treated by discectomy,interbody fusion,pedicle screw fixation,and modified lamina replantation. There were 33 males and 30 females with an average age of 48.4 years old ranging from 22 to 68 years old. The average duration of disease was 38.8 months ranging from 3 months to 13 years. All patients had lower back and leg pains. X-ray,CT and MR results showed unstable lumbar intervertebral disc herniation. Preoperative and postoperative ODI,JOA scores,complication incident rates,radiographic healing rates,and lower back and leg pain recurrence rates were observed and recorded.
Results: Sixty-two incisions were healed at first stage,1 at second stage. There were no complications such as deep vein thrombosis,intervertebral infection and so on. Sixty-one patients were followed up for more than one year,and the mean duration was 33 months. Nerve and dural injury occurred in 2 patients and 1 patient respectively. One-year fusion happened in 58 patients while the recurrence of lower back pain and leg pain after 1 year were noted in 4 patients and 1 patient respectively. ODI,and JOA scores were respectively re-assessed at 2 weeks,6 months and 1 year after the operation,and the results showed a significant difference from the preoperative scores (P<0.05).
Conclusion: Modified lamina replantation for unstable lumbar intervertebral disc herniation showed lower rates of dural and nerve damage,as well as a higher lamina healing rate,lower back and leg pain recovery rate,and a better clinical score. It is a safe and efficient operation choice for lumbar spine surgery. |
| KEY WORDS Lumbar vertebrae Intervertebral disk displacement Spinal fusion Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘琮,徐洪海,邹庆洋,郭雄,刘宗智,罗振群,李勇,祁洁,刘军,任鹏宇,范亚一.改良腰椎板截骨回植治疗失稳性腰椎间盘突出症[J].中国骨伤,2013,26(11):918~922 |
| 英文格式: | LIU Cong,XU Hong-hai,ZOU Qing-yang,GUO Xiong,LIU Zong-zhi,LUO Zhen-qun,LI Yong,QI Jie,LIU Jun,REN Peng-yu,FAN Ya-yi.Treatment of unstable lumbar intervertebral disc herniation by modified lamina osteotomy replantation[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(11):918~922 |
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