经后路单侧入路治疗下腰椎间盘脱出并腰椎不稳症

目的探讨单侧椎弓根固定、椎间盘切除、椎间融合治疗下腰椎椎间盘脱出并椎间不稳症的疗效。方法2006年1月—2008年10月对26例下腰椎间盘脱出并椎间不稳症的患者采用单侧椎弓根钉固定＋间盘切除＋椎间融合术治疗,所有患者均行一侧部分椎板、关节突切除,病变间盘摘除,同侧椎弓根固定＋椎间融合术。结果所有患者均顺利完成手术,术后患者腰痛及下肢疼痛均明显缓解,随访7—30个月,平均18个月,依Prolo评分标准评分,术前（4±0.3）分,术后半年以上（9.5±1.1）分（P〈0.01）。结论单侧椎板减压＋间盘切除＋椎间融合术治疗脱出型腰椎间盘突出并椎间不稳症效果优良,既达到稳定病变脊柱节段,又减少了术中出血,缩短了手术时间,是一种新的、安全有效的治疗方法。

Posterior unilateral approch in conjunction with discectomy and interbody fusion in the treatment of lumbar disc herniation

Objective To explore the clinical effect of unilateral pedicle fixation in conjunction with discectomy and interbody fusion in treating lumbar disc herniation.Methods Twenty-six cases with lumbar disc herniation were reviewed.All cases were underwent unilateral laminectomy and transforaminal lumbar interbody fusion combined with unilateral pedicle screw fixation.Results Operation was successfully performed on all cases with a mean operative time of 75min and mean average blood loss of 120ml.The mean time of follow-up was 18 months（range,7-30 months）.Prolo score improved from 4 to 9.5 before and after operation,and was 9.0 at final follow-up.Conclusion Unilateral laminectomy and discectomy in conjunction with unilateral pedicle screw fixation and transforaminal lumbar interbody fusion is a safe and effective method in treating lumbar disc herniation.It is a safe,relative simple and effective method with the advantages of stabilizing diseased lumbar segment,decreasing blood loss and operating time.