后路椎间盘切除椎体融合治疗椎间盘源性下腰痛

目的：观察后路腰椎间盘切除椎体融合治疗椎间盘源性下腰痛的近期疗效。方法：将经临床检查和推间盘造影确诊为椎间盘内紊乱的２７例患者分为两者，一组行椎板开窗间盘切除椎体间Ｃａｇｅ内植骨术（Ｃａｇｅ组），另一组行椎板开窗间盘切除椎体间植骨经椎弓根内固定术（ＰＳＦ组），术后随访２～３年，观察患者腰痛改善和腰椎融合情况。结果：腰痛改善率：术后第１年Ｃａｇｅ组为８９％，ＰＳＦ组为９１％，术后第２年Ｃａｇｅ组为９３％，ＰＳＦ组为９４％，腰椎融合率：术后第１年Ｃａｇｅ组为９２％、ＰＳＦ组为９３％，随访期内两组各有１例未融合。结论：后路椎间盘切除椎体间Ｃａｇｅ内植骨或椎间盘切除椎体间植骨经椎弓根内固定治疗椎间盘源性下腰前，近期疗效满意。

Posterior disc excision and interbody fusion for the treatment of lumbar discogenic pain

Objective:To investigate clinical results of disc excision and interbody fusion for the treatment of lumbar discogenic pain.Method:Twenty seven patients suffered from lumbar discogenic pain were randomly classified into two groups, one group undergoing posterior disc excision and interbody fusion with Cage posting(Cage group,13 patients),the other group undergoing posterior disc excision and interbody fusion with pedicle screw fixation(PSFgroup,14 patients).Low back pain improvement and interbody arthrodesis were followed up at least two years.Result:Low back pain improvement was 89% in Cage group,and 91% in PSF group one year after surgery.Pain improvement was up to 93% in Cage group,and 94% in PSF group two years after surgery.A solid arthrodesis rate was 92% in Cage group,and 93% in PSF group one year after surgery.Only two cases have failed to interbody fusion,one in cage group,another in PSF group.Conclusion:Posterior disc excision and interbody fusion for the treatment of lumbar discogenic pain show an early satisfactory result. O