椎间盘突出症与椎间不稳310例治疗效果分析

目的探讨椎间不稳与腰椎间盘突出的发生、发展及对手术或保守治疗的影响和作用。方法310例病例分为手术组和保守治疗组，手术治疗69例，采用开窗摘除突出的椎间盘。有滑脱者进行椎间植骨融合；保守治疗136例，采用床头牵引，每天牵引2～4小时，尽量卧床休息，下床活动时腰围固定，治疗时间4～8周。结果手术组50例术后得到随访，随访时间平均27（6～60）个月，2例有腰痛和下肢疼痛，较术前减轻，1例会阴部感觉减退，优良率94％。保守治疗组110侧得到随访，平均随访时间24（6～72）个月。89例症状消失和明显好转，优良率为81％。结论椎间不稳对椎间盘突出的发生及发展有很重要的影响，治疗时也不能忽视。重视腰部稳定，对手术和保守治疗都很重要。

Analysis of the Effect Treatment for Lumbar Disc Herniation with Intervertebral Instability

Objective To discuss the influence and the effect of intervertebral instability for occurrence and development of protrusion of intervertebral disc herniation and it with surgical operation or conservative treatment. Methods 310 cases were divided into the surgical operation group and the conservative treatment group.69 cases were treated with surgical operation for opening a window to take off disc herniation and the bone fusion for spondyolisthesis.136 cases were treated conservative with bedside traction,traction for 2-4 hours everyday,lie in bed rest as far as possible,the kummerbund should be fixed while having movement.Curing time was 4-8 weeks.Results The 50 cases with surgical operation were followed-up from 6 months to 60 months,average time was 27 months.The 2 cases had the lumbago and the legs ache,comparing to mitigatory before operation.1 case had perineum felling decrease.The good rate was 94%.The 110 cases with conservative were followed-up from 6 months to 72 months,average 24 months.The symptom of 89 cases were disappear and obvious amendment.The good rate is 81%.Conclusion The intervertebral instability had very important effect on occurrence and development of portrusion of intervertebral disc herniation.It couldn't be neglected while treatment.It was very important to operation and conservative treatment for recognition loins stability and promoting intervertebral fusion.