后路单侧钉棒系统固定治疗腰骶段疾患的临床观察

目的探讨后路单侧钉棒系统固定治疗腰骶段疾患的初期手术疗效。方法2008年4月至2009年4月采用后路单侧钉棒系统固定治疗腰骶段疾患5例,男性3例,女性2例,年龄29~70岁,平均46岁,病程7~48个月,平均35.7个月。其中极外侧椎间盘突出伴钙化2例,椎间盘突出游离型1例,腰椎管狭窄1例,椎弓根峡部裂伴极外侧椎间盘突出1例。结果所有患者术后均获得随访,时间为5~16个月,平均11.5个月。术前、术后及末次随访按日本骨科学会(JOA)平均评分分别为7.2±0.8、13.6±0.5、14.2±0.4;疼痛视觉模拟评分(VAS)评分平均分别为7.6±0.5、2.4±0.6、1.8±0.4。两项指标均有显著改善,术后及末次随访较术前差异有统计学意义(P<0.01),而末次随访与术后比较差异无统计学意义(P>0.05)。至末次随访,内固定无松动、断裂等,椎间植骨均获得骨性融合。结论后路单侧钉棒系统固定对治疗腰椎管狭窄单侧症状、极外侧腰椎间盘突出、单侧腰骶椎管内占位等,取得明显的初期临床疗效,但本组例数较少,随访时间较短,中、远期疗效仍需进一步观察。

Clinical observation of unilateral posterior screw-rod system fixation for the treatment of lumbosacral disorders

Objective Discuss the posterior screw-rod system unilateral fixation for the treatment of lumbosacral diseases.Method From April 2008 to April 2009,use the posterior screw-rod system unilateral fixation for the treatment of five cases of lumbosacral illness.There were 3 male,2 female with average age of 46 years(range 29 to 70 years),average course of disease 35.7 months(range 7 to 48 months).Far lateral prolapse of lumbar intervertebral disc associated with calcification in two cases,one cases of sequestered disc herniation,lumbar spinal stenosis in one case,the pedicle isthmic with one cases of far lateral prolapse of lumbar intervertebral disc.Result All patients were followed up from 5 to 16 months(average 11.5 months).Preoperation,postoperatively and final follow-up,the average JOA score were 7.2±0.8,13.6±0.5,14.2±0.4;the average VAS score were 7.6±0.5、2.4±0.6、1.8±0.4.Two indicators were significantly improved,the difference was statistically significant(P<0.01),the last follow-up and postoperatively compared with no significant difference(P>0.05).All patients were cured and instrumentations were not loosed and broken.Interbody bone graft had fusion.Conclusion Unilateral posterior screw-rod fixation system for treating lumbar spinal stenosis with unilateral symptoms,far lateral prolapse of lumbar intervertebral disc,unilateral lumbosacral spinal space-occupying,achieving early apparent clinical efficacy,but patients in this group the number of cases less shorter follow-up,medium and long-term efficacy still needs further observation.