微创后路椎间融合治疗退行性变腰椎疾患的疗效观察

目的评估微创后路单侧椎弓根螺钉结合关节突螺钉固定椎间融合治疗退行性变腰椎疾患的有效性及安全性。方法回顾性分析2009年5月至2011年10月保定市第一中心医院应用单侧椎弓根螺钉结合关节突螺钉固定椎间融合治疗的12例腰椎节段性不稳和腰椎间盘突出患者,采用模拟视觉评分(VAS)、日本骨科学会(JOA)评分对患者的疼痛进行评估。结果患者术前和术后1周、3个月、12个月腰腿痛VAS及JOA评分的比较,差异有统计学意义(F=74.167,161.332,P<0.05),随术后时间的延长患者VAS逐渐减低,术后12个月时最低,JOA评分随时间的延长而增加,但术后3个月与术后12个月比较差异无统计学意义(P>0.05);治疗后,10例患者获得良好的骨性融合(83%)。结论微创单侧椎弓根螺钉结合关节突螺钉固定植骨融合内固定治疗退行性变腰椎疾患安全有效。

Observation on Effect of Minimally Invasive Posterior Lumbar Interbody Fusion Treatment for Degenerative Lumbar Spine Diseases

Objective To evaluate the effectiveness and safety of mini-invasive posterior lumbar inter- body fusion using unilateral pedicle screw and facet screw fixation for degenerative lumbar diseases. Methods Retrospective analysis of 12 patients affected by segmental instability and disc herniation of the lumbar spine who underwent lumbar interbody fusion combined with unilateral pedicle screw and facet screw fixation in Baoding First Central Hospitalfrom May 2009 to Oct. 2011 was done. The pain of patients was assessed by visual analogue scales （ ~AS ） and Japanese orthopaedic association （ JOA ） scores. Results The ~AS scores,JOA scores of preoperative and postoperative 1 week, 3 months, 12 months were statistically signifi- cantly different（ F = 74. 167,161. 332, P 〈 0.05 ） , the postoperative VAS sores of patients were gradually reduced with extension of the time, it was minimum in postoperative 12 months, JOA scores increased with extension of the time, but it was not statistically significantly different between postoperative 3 months and 12 months（ P 〉 0.05 ）. Bone fusion was considered as solid in ten patients after operation（ 83% ）. Conclusion Minimally invasive posterior lumbar interbody fusion fixation using unilateral pedicle screw and facet screw is a safe and valid treatment for degenerative lumbar diseases.