RSS椎弓根钉内固定加植骨融合治疗腰椎间盘突出并腰椎不稳的应用研究

目的探讨腰椎间盘突出并腰椎不稳患者采用RSS椎弓根钉内固定加植骨融合进行治疗的临床效果。方法收集2008年8月-2013年2月到我院就诊的腰椎间盘突出并腰椎不稳患者72例作为本次的研究对象。将所有的患者按照手术方式的不同分为观察组和对照组，每组各36例，对照组2010年8月以前患者采用髓核摘除、后路关节突单纯植骨的手术方法，观察组2010年8月以后采用RSS椎弓根钉内固定加植骨融合进行治疗，比较两组患者的临床效果。结果两组患者末次随访JOA评分明显高于术前，观察组患者末次随访JOA评分、改善率及JOA优良率、植骨融合率与对照组比较明显较高，差异具有统计学意义（P〈0．05）。两组患者末次随访时的ODI评分明显低于术前，末次随访时的ODI评分在两组间比较，差异具有统计学意义（P〈0．05）。结论采用RSS椎弓根钉内固定加植骨融合对腰椎间盘突出并腰椎不稳患者进行治疗能够使症状得到显著的改善，临床效果较为满意。

Application of RSS pedicle screw fixation and bone fusion in the treatment of lumbar disc herniation complicated with lumbar instability

Objective To investigate the effect of lumbar disc herniation were treated with RSS pediele screw frxation and bone fusion and clinical effect of treatment. Methods Seventy-two patients of lumbar disc herniation and lumbar instability were selected from August 2008 to 2013 February in our hospital as the research objects, all the patients according to different operation mode were divided into the observation group and control group, with 36 cases in each group, the control group before 2010 August were treated with nucleus pulposus, processus posterior bone grafting; the observation group after 2010 August were treated with RSS pedicle screw fixation and fusion for treatment, com- pared the clinical effect of two groups. Results JOA score at the end of the follow-up of two groups was significantly higher than that of before operation, JOA score at the last follow-up , improvement rate and excellent and good rate of JOA,the fusion rate of bone graft in the observation group were higher than the control group, the differences were significant （P 〈 0.05）. ODI score at the last follow-up of two groups was significantly lower than preoperative, differences at the last follow-up ODI score between the two groups was significant （P 〈 0.05）. Conclusion RSS pedicle screw internal fixation and bone grafting fusion for lumbar disc herniation treatment can make the symptoms improved significantly, satisfactory clinical effect.