| 微创通道下单侧椎弓根螺钉固定椎间融合治疗青年脱出型腰椎间盘突出症 |
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投稿时间：2018-08-01
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| 作者 | Author | 单位 | Address | E-Mail |
| 张力 |
ZHANG Li |
福建医科大学附属漳州市医院, 福建 漳州 363000 |
Department of Spinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical Univercity, Zhangzhou 363000, Fujian, China |
chinadoctorzhang@163.com |
| 黄爱娥 |
HUANG Ai-e |
福建医科大学附属漳州市医院, 福建 漳州 363000 |
Department of Spinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical Univercity, Zhangzhou 363000, Fujian, China |
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| 期刊信息：《中国骨伤》2019年，第32卷，第3期，第220-224页 |
| DOI：10.3969/j.issn.1003-0034.2019.03.005 |
| 基金项目: |
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中文摘要:
目的：探讨经Quadrant通道下行单侧椎弓根螺钉固定椎间植骨融合技术治疗青年脱出型腰椎间盘突出症的临床疗效。
方法：2015年1月至2017年1月，对18例青年脱出型腰椎间盘突出症患者采用在Quadrant通道（可扩张管道系统）下摘除脱出髓核、单侧椎弓根螺钉固定、椎体间植骨融合技术进行治疗。其中男10例，女8例，年龄20~28岁，平均22.5岁。对术前，术后1、3个月，末次随访时的VAS、JOA评分分别进行比较。末次随访按术后好转率、椎间融合率来评价症状改善及植骨融合情况。
结果：18例患者均获得随访，时间14~34个月，平均24.3个月，切口均Ⅰ期愈合，无神经根损伤、螺钉松动、断裂、椎间融合器下沉等并发症。术后VAS评分、腰椎JOA评分均较术前明显改善（P<0.05）。末次随访腰椎功能显著改善，术后好转率优10例，良6例，可2例。术后3~6个月18例患者均达到骨性愈合。
结论：微创通道下单侧椎弓根螺钉固定、椎间融合技术治疗青年脱出型腰椎间盘突出症，具有手术时间短、创伤小、住院时间短等优点，在严格掌握手术适应证的前提下是一种安全可行的手术方法。 |
| 【关键词】Quadrant通道 单侧椎弓根螺钉固定 青年 脱出型腰椎间盘突出症 椎间融合 |
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| Unilateral pedicle screw fixation and lumbar interbody fusion under the Quadrant tunnel for the treatment of prolapsed lumbar disc herniation in young patients |
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ABSTRACT
Objective:To explore the clinical effect of unilateral screw fixation and lumbar interbody fusion under the Quadrant tunnel to treat prolapsed lumbar disc herniation in young patients.
MethodsBetween January 2015 and January 2017,18 young patients with prolapsed lumbar disc herniation were treated with unilateral pedicle screw fixation and lumbar interbody fusion under Quadrant tunnel. Among them,there were 10 males and 8 females,aged from 20 to 28 years old with an average of 22.5 years. The VAS,lumbar JOA scores were compared before sutgery,1 and 3 months after surgery and at the final follow-up. The improvement of clinical symptoms and bone fusion rate were evaluated according to the improved rate of JOA score and X-rays data at the final follow-up.
ResultsAll 18 patients were followed up from 14 to 34 months with an average of 24.3 months. All incisions got primary healing,and no nerve root injury,screw loose or rupture,threaded fusion cage sink or other complications were found. The postoperative VAS,lumbar JOA scores were improved significantly(P<0.05). Neurologic function improved significantly in the final follow-up. The postoperative JOA improvement rate was excellent in 10 cases,good in 6 cases,and fair in 2 cases. Postoperative bone graft fusion rate was 100% at 3 to 6 months.
ConclusionUnilateral screw fixation and lumbar interbody fusion under the Quadrant tunnel is an effective and safe method in treating prolapsed lumbar disc herniation for young patients,it has advantage of short operation time,small trauma and short hospitalization time. However,the indications should be well considered. |
| KEY WORDS Quadrant tunnel Unilateral pedicle screw fixation Young Prolapsed lumbar disc herniation Interbody 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: | 张力,黄爱娥.微创通道下单侧椎弓根螺钉固定椎间融合治疗青年脱出型腰椎间盘突出症[J].中国骨伤,2019,32(3):220~224 |
| 英文格式: | ZHANG Li,HUANG Ai-e.Unilateral pedicle screw fixation and lumbar interbody fusion under the Quadrant tunnel for the treatment of prolapsed lumbar disc herniation in young patients[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(3):220~224 |
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