可扩张通道下单侧椎弓根内固定融合治疗腰椎间盘突出症的临床疗效研究简

目的 对比分析Quadrant可扩张通道下单侧椎弓根内固定融合治疗术与常规双侧椎弓根内固定融合治疗术对腰椎间盘突出症的治疗效果,探讨腰椎间盘突出症的最优治疗方式.方法 回顾性分析2011年5月至2013年5月来院就诊的腰椎间盘突出症患者80例,按照手术方式的不同分为观察组40例（行Quadrant通道下单侧椎弓根内固定融合治疗）和对照组40例（行常规双侧椎弓根内固定融合治疗）,比较两组手术用时、出血量、术后住院时间,并使用改良Macnab疗效评定标准、视觉模拟评分系统（VAS）评价手术效果.结果 观察组手术用时（102.6±8.2）min、出血量（182.7±38.6）ml,与对照组相比差异明显（P〈0.05）;术后住院时间为（13.6±2.1）d、术后Macnab评定有效率为92.5%、术前与随访视觉模拟评分分别为（8.6±1.7）分、（1.6±2.2）分,与对照组比较无显著差异（P〉0.05）.观察组并发症发生率为7.5%,对照组并发症发生率为15.0%,对照组多于观察组,但组间差异无统计学意义（P〉0.05）.结论 观察组与对照组在治疗有效率方面没有显著差异,但是观察组的平均出血量较少、术后住院时间较短、并发症发生率也较低,优于对照组,故采用Quadrant通道下单侧椎弓根内固定融合术是治疗腰椎间盘突出症的一种良好方式,有较大的临床实用价值.

Study on clinical efficacy of unilateral pedicle screw fixation and fusion assisted by Quadrant system in treatment of lumbar disc herniation

Objective To compare the clinical efficacy of unilateral pedicle screw fixation and fusion with bilateral pedicle screw fixation and fusion, and to provide reference for treatment of lumbar disc herniation. Methods The clinical data of 80 patients with lumbar disc hemiation in this hospital during May 2011 to May 2013 were retrospectively analzed. They were divided into observation group and control group by different ways of operation. Patients in observation group received unilateral pedicle screw fixation and fusion assisted by Quadrant system, and patients in control group received bilateral pedicle screw fixation and fusion. The difference in efficacy, operating time, intraoperative blood loss and postoperative hos- pital stay were compared between these two groups. The evaluation of their therapeutic effect had been carried out by using Macnab and VAS scoring systems. Results In observation group, the average operating time was 102.6 ± 8.2 rain with mean blood loss of 182.7 ± 38.6 ml ; mean postopera- tive hospital stay was 13.6 ±2.1 d; their difference was significant compared with those of control group. The effective rate of postoperative assess- ment for macnab was 92.5%. The preoperative VAS scores were 1.6 ± 2.2 scores, and the mean postoperative VAS scores were 8.6± 1.7 scores, there was no significant difference between these two groups. The complication rate of observation group was 7.5% which was lower than that of con- trol group （ 15.0% ）, but their difference was not significant （ P 〉 0.05 ） . Conclusion In comparison with control group, patients in observation group have shorter operating time, less blood loss and shorter postoperative hospital stay, hence unilateral pedicle screw fixation and fusion assisted by Quadrant system is a reliable and effective therapeutic approach, and it is worthy to be applied for clinical reference.