不同入路在高位腰椎间盘突出症减压植骨融合固定术中的效果及安全性

目的 探究前后路减压植骨融合固定术治疗高位腰椎间盘突出症的效果及其安全性.方法 选取2012年5月-2015年8月在邯郸钢铁集团有限责任公司职工医院确诊的105例高位椎间盘突出症患者.按照治疗方法不同将患者分为对照组(52例)和研究组(53例),对照组接受前路减压植骨融合固定术治疗,研究组接受后路减压植骨融合固定术治疗.比较两组手术效果指标、疼痛视觉模拟评分法(vAS)评分、Oswestry功能障碍指数问卷表(ODI)评分及治疗效果,同时比较术后并发症情况.结果 研究组术中出血量、手术时间、住院时间及切口愈合时间均明显少于对照组(P＜0.01),术后VAS和ODI评分均明显低于对照组(P＜0.01),手术优良率明显高于对照组(P＜0.05),并发症总发生率明显低于对照组(P＜0.01).结论 后路减压植骨融合固定术治疗高位腰椎间盘突出症能显著降低手术时间和术中出血量,且能减少并发症发生、降低术后VAS及ODI评分.

Effect and Safety of Different Approaches Methods in Application of Decompression,Bone Graft and Internal Fixation for High Lubar Intervertebral Disc Protrusion

Objective To investigate effect and safety of anterior and posterior approaches in application of decompression,bone graft and internal fixation for high lubar intervertebral disc protrusion.Methods A total of 105 patients with high lubar intervertebral disc protrusion admitted during May 2012 and August 2015 were divided into control group (n =52) and research group (n =53) according to different treatment methods.Control group was treated with anterior decompression,bone graft and internal fixation,while research group was treated with posterior decompression,bone graft and internal fixation.Operative effect indexes,pain visual analogue scale (VAS) score,Oswestry dysfunction index questionnaire (ODI) score and treatment effect were compared,and incidence rate of complications was also compared synchronously between the two groups.Results In research group,values of intraoperative bleeding volume,operative time,length of stay and wound healing time were significantly lower (P ＜ 0.01);postoperative VAS and ODI scores group were significantly lower (P ＜ 0.01);excellent rate of operation was significantly higher (P ＜ 0.05);the total incidence rate of complications was significantly lower than those in control group (P ＜ 0.01).Conclusion Posterior decompression,bone graft and internal fixation in treatment of high lubar intervertebral disc protrusion can significantly decrease operative time and intraoperative bleeding volume,reduce incidence rate of complications,postoperative VAS and ODI scores.