单侧固定治疗腰椎间盘突出并腰椎不稳症

目的探讨后路半椎板减压、单侧椎弓根螺钉固定、椎间植骨融合治疗腰椎间盘突出并腰椎不稳症的临床疗效。方法 2007年1月-2010年1月对42例腰椎间盘突出并腰椎不稳症的患者采用后路单侧椎弓根螺钉固定、单侧椎板切除减压、髓核摘除、椎间植骨融合治疗,术前常规摄腰椎正侧位、腰椎过伸过屈动力位片、CT及MRI,了解椎管狭窄及椎体不稳程度;术后1周带腰围或佩戴支具下床活动。结果所有患者均顺利完成手术,术后患者腰痛及下肢麻木、疼痛症状均明显缓解,40例均获得随访,随访时间8-24个月,平均18个月。根据JOA（日本骨科协会评估治疗分数）评分评估神经功能改善率的评定标准,优良率85%。X线片显示椎间植骨融合良好。结论经后路单侧椎弓根螺钉固定、单侧椎板切除减压、髓核摘除、椎间植骨融合治疗腰椎间盘突出并腰椎不稳症效果优良,具有创伤小、风险小、医疗费用少等优点,但远期疗效仍需进一步随访及研究。

Cantilever treatment of lumbar disc herniation and lumbar instability

Objective ] Explore the posterior half laminectomy, unilateral pedicle screw and interbody fusion clinical efficacy for the treatment of lumbar disc herniation and lumbar instability. Methods ] January 2007-January, 42 casesof lumbar disc herniation and lumbar instability were treated with posterior unilateral pedicle screw fixation, unilateral laminectomy, discectomy and interbody fusion treatment, The conventional camera preoperative lateral lumbar spine,lumbar held out his flexor dynamic bit-slice CT and MR1, to understanding spinal stenosis and vertebral instability degree; After one week with the waist or wear a brace ambulation. Resluts ] All patients successfully completed the surgery,postoperative patients with low back pain and numbness, pain symptoms were significantly alleviate.40 patients were followed up for 8 to 24 months, an average of 18 months.According to the JOA （Japanese Orthopaedic Association assesstreatment scores） ratings assess nerve function improvement rate assessment standards, excellent rate of 85%.The X-ray showed interbody fusion. Conclusion ] By posterior unilateral pedicle screw fixation, unilateral laminectomy removal ofdecompression discectomy and interbody fusion for the treatment of lumbar disc herniation and lumbar instability syndrome excellent effect.Trauma, the risk is small, less medical expenses, but the long-term efficacy need further follow-up andresearch.