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单侧椎板减压椎弓根螺钉固定椎间融合术治疗腰椎间盘突出症
何蔚,何海龙,许国华,范纯泉,张桦,蒋玉权,朱云荣,叶晓健*
0
(第二军医大学长征医院骨科,上海 200003)
摘要:
目的:探讨单侧神经减压椎间融合椎弓根螺钉固定治疗腰椎间盘突出症的应用价值和实际疗效。方法:自2006年2月至2008年2月,对24例患者行单侧神经减压椎间融合椎弓根螺钉固定术。平均随访1年。记录手术时间、失血量、住院时间、短期与中期临床疗效。结果:在平均1年的随访期内,患者术前腰痛和(或)下肢疼痛症状术后均有缓解。末次随访时,应用Oswestry指数P0~P5分级的患者分别为5、11、6、2、0、0例。用改良JOA标准评价临床结果,优18例、良4例、可2例。优良率91.67%。结论:单侧固定可以用于需要行椎间融合的椎间盘突出症和Ⅰ度腰椎滑脱症患者的治疗,中期随访临床效果优良。
关键词:  腰椎间盘突出症  椎弓根螺钉固定  椎间融合
DOI:10.3724/SP.J.1008.2009.0537
投稿时间:2008-11-20修订日期:2009-03-15
基金项目:
Unilateral vertebral plate decompression,interbody fusion and pedicle screw fixation in treatment of lumbar disc herniation
HE Wei,HE Hai-long,XU Guo-hua,FAN Chun-quan,ZHANG Hua,JIANG Yu-quan,ZHU Yun-rong,YE Xiao-jian*
(Department of Orthopedics,Changzheng Hospital,Second Military Medical University,Shanghai 200003,China)
Abstract:
Objective:To explore the application and efficiency of unilateral vertebral plate decompression,interbody fusion and pedicle screw fixation in treatment of lumbar disc herniation. Methods:From Feb. 2006 to Feb. 2008,24 patients underwent unilateral vertebral plate decompression,interbody fusion and pedicle screw fixation. The patients were followed up for one year and the following data were recorded:operation time,estimated blood loss,duration of hospital-stay,short-term and medium-term clinical outcome. Results:All patients had their low back pain and/or lower extremity radicular pain improved during the one year follow-up. The last follow-up showed that the numbers of patients with Oswestry Disability Index(ODI) P0-P5 were 5,11,6,2,0,and 0,respectively. The clinical outcomes determined by modified JOA criteria showed that 18 patients had excellent outcomes,4 had good outcomes,and 2 had fair outcomes,with the excellent and good outcomes occupying 91.67%. Conclusion:The unilateral fixation can be used in patients with lumbar disc herniations who need lumbar spinal fusion. The medium-term outcomes is satisfactory.
Key words:  lumbar disc herniation  transpedicular screw fixation  interbody fusion