后路椎体间或横突间融合治疗椎间盘源性下腰痛

目的 观察椎体间或横突间融合治疗椎间盘源性下腰痛的手术疗效。方法 经椎间盘造影检查,有32例患者被确诊为椎间盘源性下腰痛。其中17例行后路椎间盘切除椎体间cage植骨,15例行后路椎间盘切除横突间植骨RF内固定。术后随访2－4年,观察患者腰痛改善和腰推融合情况。结果 术后1年患者腰痛较术前平均改善者在椎间融合组为87％,横突融合组为76%。术后2年腰痛较术前平均改善者在椎间融合组为89％,横突融合组为81％。术后1年腰椎融合率在椎间融合组为88％,横突融合组均为87％。术后2年腰椎融合率在椎间盘融合组为92％,横突融合组均为90％。结论 后路椎体间cage植骨融合术治疗椎间盘源性下腰痛,术后近中期腰痛改善率优于经椎弓根固定横突间融合术。椎间融合治疗是治疗椎间盘源性下腰痛的首选术式。

Posterior interbody fusion or posterolateral fusion for discogenic low back pain

Objective To investigate the surgical results of posterior interbody fusion or posterolateral fusion for discogenic low back pain. Methods Thirty two patients suffering from lumbar discogenic pain were randomly divided into two groups, one group undergoing posterior interbody fusion with cage (cage group, 17 patients), the other group undergoing posterolateral lumbar fusion with RF fixation (RF group, 15 patients). Low back pain improvement and lumbar fusion rate were followed up for at least two years. Results The low back pain improvement rate was 87% in cage group, and 76% in RF group one year after surgery. Pain improvement rate was up to 89% in cage group,and 81% in RF group two years after surgery. A solid arthrodesis rate was 88% in cage group and 87% in RF group one year after surgery, and was up to 92% in cage group, and 90% in RF group two years after surgery. Conclusion Posterior interbody fusion for lumbar discogenic pain have a better clinical result than posterolateral fusion for discogenic low back pain. Interbody fusion is of choice for lumbar discogenic pain.