| 单侧钉棒系统辅助对侧经皮关节突椎弓根螺钉固定治疗下腰椎退变性疾病 |
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投稿时间：2014-05-06
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| 作者 | Author | 单位 | Address | E-Mail |
| 邵荣学 |
SHAO Rong-xue |
浙江中医药大学, 浙江 杭州 310053 |
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| 罗鹏 |
LUO Peng |
温州医科大学附属第二医院骨科, 浙江 温州 325027 |
Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China |
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| 林焱 |
LIN Yan |
温州医科大学附属第二医院骨科, 浙江 温州 325027 |
Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China |
spinelin@163.com |
| 徐华梓 |
XU Hua-zi |
温州医科大学附属第二医院骨科, 浙江 温州 325027 |
Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China |
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| 池永龙 |
CHI Yong-long |
温州医科大学附属第二医院骨科, 浙江 温州 325027 |
Department of Orthopaedics, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China |
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| 期刊信息：《中国骨伤》2015年，第28卷，第4期，第318-322页 |
| DOI：10.3969/j.issn.1003-0034.2015.04.006 |
| 基金项目: |
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中文摘要:
目的:探讨单侧钉棒系统辅助对侧经皮关节突椎弓根螺钉固定治疗下腰椎退变性疾病的置钉技巧和临床疗效。
方法:2009年1月至2011年12月,收治22例下腰椎退变性疾病患者,其中男16例,女6例;年龄32～71岁,平均(51.1±10.6)岁;单节段20例,双节段2例。22例患者均采取经椎间孔腰椎体间融合(TLIF)术结合单侧钉棒系统辅助对侧经皮关节突椎弓根螺钉内固定治疗,通过视觉模拟评分(VAS)和Oswestry 功能障碍指数(ODI)对患者的临床疗效进行评定。
结果:所有患者获得随访,时间1～2.5年,平均18个月。术后出现脑脊液漏1例,术后第3天出现减压侧下肢疼痛麻木1例。22例均获得骨性融合,未出现椎弓根螺钉与关节突椎弓根螺钉松动、移位、断裂及椎间融合器移位现象。腰椎VAS从术前的8.24±0.72减少至末次随访的3.18±0.66,ODI 从术前的36.72±6.84下降至末次随访的4.36 ±1.12.患者症状明显改善(P<0.05).
结论:单侧钉棒系统辅助对侧经皮关节突椎弓根螺钉固定术具有创伤小、稳定性好、融合率高和并发症少等优点,是治疗下腰椎退变性疾病较好的手术方式。 |
| 【关键词】下腰椎退变性疾病 椎间孔腰椎体间融合 外科手术,微创性 |
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| Treatment of low lumbar degenerative disease with unilateral pedicle screw combined with contralateral percutaneous transfacet screws fixation |
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ABSTRACT
Objective:To explore the operative skills and effect of unilateral pedicle screw combined with contralateral percutaneous transfacet screws fixation in treating degenerative low lumbar disease.
Methods:From January 2009 to December 2011, 22 patients with degenerative low lumbar disease were treated with transforaminal lumbar interbody fusion, during the operations, unilateral pedicle screw and contralateral percutaneous transfacet screw fixation were performed. There were 16 males and 6 females, aged from 32 to 71 years old with an average of (51.1±10.6) years, including single segment in 20 cases and two segments in 2 cases. Clinical effects were evaluated according to visual analogue score(VAS) and Oswestry Disability Index(ODI).
Results:All patients were followed up from 1 to 2.5 years with an average of 18 months. One case complicated with leakage of cerebrospinal fluid after operation and 1 case with lower limb pain of decompression-side on the 3rd day after operation. Twenty-two patients got bony fusion. There were no instability and evidence of instrument failure during follow-up. The VAS and ODI score decreased from preoperative 8.24±0.72, 36.72±6.84 respectively to 3.18±0.66, 4.36±1.12 at the final follow-up(P<0.05).
Conclusion:Unilateral pedicle screw combined with contralateral percutaneous transfacet screw fixation is safe and feasible surgical technique in treating low lumbar degenerative disease. It has advantages of little trauma, rigid fixation, high fusion rate, and less complication, etc. |
| KEY WORDS Degenerative low lumbar diseases Transforaminal lumbar interbody fusion Surgical procedures,minimally invasive |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邵荣学,罗鹏,林焱,徐华梓,池永龙.单侧钉棒系统辅助对侧经皮关节突椎弓根螺钉固定治疗下腰椎退变性疾病[J].中国骨伤,2015,28(4):318~322 |
| 英文格式: | SHAO Rong-xue,LUO Peng,LIN Yan,XU Hua-zi,CHI Yong-long.Treatment of low lumbar degenerative disease with unilateral pedicle screw combined with contralateral percutaneous transfacet screws fixation[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(4):318~322 |
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