QUADRANT通道下单侧椎弓根固定单枚cage植入与双侧固定治疗LDH的比较分析

目的比较分析QUADRANT通道辅助下单侧椎弓根螺钉固定加单枚cage植入术和传统双侧固定术治疗腰椎间盘突出症的临床效果。方法将我科2008年2月至2010年10月收治的56例腰椎间盘突出症患者随机分成两组，每组28例，分别采用QUADRANT通道辅助下单侧椎弓根螺钉固定加单枚cage植人术和传统双侧固定术治疗，术后采用改良Macnab评分标准评价临床疗效。结果单侧组和双侧组手术时间分别为85～140min和1。0～170min，平均101min和126min；术中出血量分别为100～350mL和150～420mL，平均174mL和242mL，两组比较差异均有统计学意义。术后随访单侧组平均25．2个月，双侧组平均26．4个月。改良Macnab标准评分单侧组优良率为96．4％，双侧组优良率为92．9％，两者比较差异无统计学意义。复查见椎间植骨融合良好，无内固定松动、断裂及融合器移位等情况。结论与双侧固定相比，QUADRANT通道辅助下单侧椎弓根螺钉固定加单枚cage植入术治疗腰椎间盘突出症可以获得相同的临床疗效，但具有手术时间短、术中出血量少、组织损伤轻等优点。

Preliminary Evaluation of Unilateral Pedicle Screw Fixation Combined with Single Cage Implantation for the Treatment of Lumbar Disc Herniation Assisted by QUADRANT System

Objective To evaluate the clinical outcomes of unilateral pedicle screw fixation combined with single cage implantation assisted by QUADRANT system for the treatment of lumbar disc herniation. Methods From Feb 2008 to Oct 2010,56 patients with lumbar disc herniation were divided into two groups randomly ,in which 28 cases received operation of unilateral pedicle screw fixation combined with single cage implantation assisted by QUAD- RANT system and another 28 cases received operation of traditional bilateral fixation. Clinical outcomes were deter- mined using the modified MacNab criterion. Results In unilateral group,operation time was 85~ 140 minutes. （101 minutes in average ,and blood loss was 100~350 mL, 174 mL in average. In bilateral group ,operation time was 100~ 170 minutes） 126 minutes in average,and blood loss was 150~420 mL, （242 mL in average）. There was statistical significance between the two groups in both operation time and blood loss. All patients were followed up and the mean period of follow-up was 25.2 months in unilateral group ,while 26.4 months in bilateral group. The excellent and good rate were 96.4% and 92.9~~ in unilateral group and bilateral group and there was no statistical significance. There were no complications related to internal fixation breakage,loosening or displacement. Conclusion Operation of uni- lateral pedicle screw hxatlon combined with single cage implantation assisted by QUADRANT system for the treat- ment of lumbar disc herniation has an excellent clinical outcome. Compared with traditional bilateral fixation way, uni- lateral way has the similar clinical outcomes, but it can minimize blood loss and tissue trauma, shorten the operative time.