前路腰椎融合术治疗复发性腰椎间盘突出症的临床效果和安全性分析#br#

目的　分析前路腰椎融合术治疗复发性腰椎间盘突出症的临床效果和安全性。 方法　回顾性研究前路腰椎融合术治疗复发性腰椎间盘突出症患者12例，记录其VAS（visual analogue scale）、ODI（oswestry disability index）、手术节段椎间隙高度、椎间孔高度、椎间隙矢状面Cobb角、腰椎前凸角、椎间融合情况、并发症等。 结果　患者术后3个月和末次随访的腰痛和腿痛VAS评分及ODI均较术前改善；术后手术节段椎间隙前高度增加3.6 mm（P<0.05）；术后手术节段椎间孔高度、矢状面Cobb角和腰椎前凸角均有改善；所有患者椎间植骨融合良好。2名患者发生融合器下沉。 结论　在严格选择适应证的前提下，前路腰椎融合术应用于复发性腰椎间盘突出症的治疗，效果较好，创伤小，术中出血少，围手术期并发症少，安全性较高。

The efficacy and safety of the surgical treatment of recurrent lumbar disc herniation with anterior lumbar interbody fusion

Objective　To observe the clinical effect and safety of anterior lumbar interbody fusion in the surgical treatment of recurrent lumbar disc herniation.　Methods　12 patients of recurrent lumbar disc herniation treated with anterior lumbar interbody fusion were included and analyzed retrospectively. VAS (visual analogue scale), ODI (Oswestry disability index), height of disc space and foramina, the cobb angle of the operated level in the sagittal plane, lumbar lordosis (LL), the status of interbody fusion and the related complications were recorded.　Results　Osphyalgia and skelagia with VAS score and ODI of 3 months after the operation and the final follow-up had improved. The anterior height of postoperative intervertebral space increased significantly by 3.6 mm (P<0.05). The height of foramina, the Cobb angle of the postoperative intervertebral space and LL also had improved. The posterior lumber intervertebral fusion were good in all patients. Fusion cage subsidence occurred in 2 patients.　Conclusions　Surgical treatment for recurrent lumbar disc herniation with anterior lumbar interbody fusion was effective and safe, which had the advantages of minimal trauma, less blood loss during the operation and less complications in perioperative period.