单侧椎弓根螺钉内固定联合椎间融合术治疗腰椎间盘突出症

摘要

目的 评价单侧椎弓根螺钉内固定联合椎间融合术治疗伴有椎间不稳的单间隙腰椎间盘突出症的临床疗效.方法 2008年3月至2009年11月,采用后入路单侧椎弓根螺钉内固定联合椎间融合术治疗26例伴有椎间不稳的单间隙腰椎间盘突出症患者,其中男性16例,女性10例;L4～5椎间盘突出症19例,L5～S1椎间盘突出症7例.记录术前疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、日本骨科学会(JOA)腰腿痛评分等功能参数,手术时间、术中出血量,术后住院天数、住院费用,末次随访时VAS、ODI及JOA评分,融合率及并发症情况.结果 所有患者均获随访16～28个月,平均22个月;末次随访时功能参数均优于术前,具有统计学差异(P＜0.001).结论 单侧椎弓根螺钉内固定联合椎间融合术治疗伴有椎间不稳的单间隙腰椎间盘突出症的中期随访表明,单侧内固定能提供与双侧内固定相同的疗效,且手术时间短、创伤小、出血少、费用低.%Objective To evaluate the effectiveness of interbody fusion with unilateral pedicle screw fixation in treatment of lumbar disc herniation. Methods Twenty-six patients with single-level lumbar disc herniation were treated with posterior interbody fusion and unilateral pedicle screws between March 2008 and November 2009, The pre- and past-operative data including visual analog scale(VAS) of pain severity, Oswestry Disability IndexCODI) and Japanese Orthopedic Association (JOA) scale were recorded and analyzed by means of t-test. Results All patients were followed up for 16 to 28 months, with an average of 22 months. There was significant difference in clinical data such as VAS, ODI and JOA scale between preoperation and final follow up (P<0.001). Conclusions Unilateral fixation is as effective as bilateral fixation when used for the treatment of single-level lumbar disc herniation with interbody fusion. The method is lower cost, saves time, and reduces the blood loss during operation.