摘要
目的探讨椎弓根螺钉固定并横突肌骨瓣植骨融合治疗合并腰椎不稳的极外侧腰椎间盘突出症的临床效果,评价横突肌骨瓣植骨融合术式的优点。方法选择极外侧腰椎间盘突出症的老年患者41例。观察组20例,采用椎弓根螺钉固定并横突间肌骨瓣植骨方法治疗;对照组21例,采用椎弓根螺钉固定并经椎间孔椎间融合器植骨融合的方法治疗;对比两组手术时间、术中出血量、术后引流量,术后椎间隙高度、植骨融合率,并采用ODI评分及VAS评分评价治疗效果。结果所有患者均获得至少18个月的随访,观察组手术时间、术中出血量、术后引流量明显少于对照组(P<0.05);两组术后3个月及18个月椎间高度较术前有明显差异(P<0.05);两组间比较术后6个月及18个月椎间高度有显著变化(P<0.05);植骨融合率对比,术后6个月时观察组明显优于对照组(P<0.05),但18个月时两组融合率无明显差异(P>0.05);VAS评分、ODI评分两组术后均较术前有明显改善(P<0.05),但两组间评分无差异(P>0.05)。结论新型肌骨瓣植骨融合的手术方法治疗老年极外侧腰椎间盘突出症创伤小、出血少、早期植骨融合率高,术后效果安全可靠。
Objective To discuss therapeutic effect of a novel paraspinal muscle-pediculated bone flap fusion to cure far-lateral lumbar disc herniation,and to evaluate the advantage of the new type muscle-pediculated bone flap fusion. Methods Forty-one patients with far-lateral lumbar disc herniation were collected. Twenty cases of observation group were treated by pedicle screw fixation and transverse process by new type muscle-bone flap fusion. Twenty-one cases of control group were treated by pedicle screw fixation and posterior lumbar interbody fusion（ PLIF）. Operation time,intraoperative blood loss,postoperative drainage,intervertebral disc height,and lumber fusion rate between two groups were compared. Furthermore,clinical outcomes in terms of oswestry disability index（ ODI）,back and leg pain visual analogue scores（ VAS） were performed before surgery,after surgery of the two groups were compared. Results All patients were received at least 18 months of follow-up,operation time,intraoperative blood loss,postoperative drainage in observation group were significantly less than the control group（ P〈0. 05）. Postoperative intervertebral height of two groups were obviously different at3 months and 18 months compared with before operation（ P〈0. 05）. Postoperative intervertebral height was obviously different at 6 months and 18 months between two groups（ P〈0. 05）.Lumber fusion rate of observation group was much better than control group at 6 months（ P〈0. 05）,but no difference of fusion rate between the two groups at 18 months（ P〈0. 05）; postoperative VAS score and ODI score were obviously improved than preoperation（ P〈0. 05）.Conclusion New type muscle-pediculated bone flaps fusion for the treatment of far-lateral lumbar disc herniation was deemed to reduce trauma and bleeding,increased early bone graft fusion rate and improved postoperative security.
出处
《哈尔滨医科大学学报》
CAS
2016年第3期223-227,共5页
Journal of Harbin Medical University
基金
国家自然科学基金资助项目(81472107)
关键词
极外侧腰椎间盘突出症
椎弓根螺钉固定
肌骨瓣植骨融合
经椎间孔椎间融合
far-lateral lumbar disc herniation
pedicle screw fixation
muscle-pediculated bone flaps fusion
transforaminal lumbar interbody fusion
