弹性棒固定治疗两节腰椎间盘突出症的疗效观察

目的探讨弹性棒固定治疗两节腰椎间盘突出的疗效,评估其对邻近节段退变的影响。方法将68例两节腰椎间盘突出患者按手术方法不同分为两组:观察组36例采用L_(3~4)、L_(4~5)椎间盘切除减压后弹性棒椎弓根钉固定术;对照组32例采用L_(3~4)、L_(4~5)椎间盘切除、横突植骨、椎弓根钉棒固定术。采用疼痛VAS评分评价临床疗效,通过X线片测量腰椎各间隙高度。结果患者均获得随访,时间15~34(26.2±2.3)个月。VAS评分:两组术后1周、末次随访时与术前比较差异均有统计学意义(P0.05),术后1周两组间比较差异无统计学意义(P0.05);末次随访时两组差异有统计学意义(P0.05)。末次随访时,上位邻近节段L_(2~3)椎间隙高度两组差异有统计学意义(P0.05),L_(3~4)、L_(4~5)节段椎间隙高度两组比较差异无统计学意义(P0.05)。结论弹性固定治疗腰椎间盘突出症取得较好的临床疗效,并能降低相邻节段退变的发生。

The efficacy observation about flexible transpedicle fixation system in treatment of two seg-ment lumbar degenerative diseases

Objective To explore the treatment effects of flexible transpedicle fixation system in two segment lumbar spinal disease , and to evaluate their influence on adjacent segments .Methods A total of 68 cases of lumbar disc herniation(LDH) were treated;36 patients underwent L3~4,L4~5 discectomy elastic rod and pedicle screw fixation system were classified as observation group; 32 patients underwent L3~4,L4~5 discectomy,lumbar fusion, pedicle screw fixation were classified as control group .The clinical effect was evaluated by pain visual analogue scale ( VAS) . The intervertebral height was measured by X-ray film.Results All patients were followed up for 15~34 (26.2 ± 2.3) months.VAS evaluation results:VAS of postoperative one week and the last follow-up was compared with the preoperative,differences were statistically significant (P<0.05);postoperation one week, they showed no significant difference between the two groups ( P>0.05 ); the difference was statistically significant at last follow-up ( P <0.05).At last follow-up, near the upper segment L2~3 intervertebral height difference was statistically significant be-tween two groups(P<0.05).About surgical segment L3~4 and L4~5 intervertebral height,there were no significant difference between the two groups ( P>0.05 ) .Conclusions Flexible transpedicle fixation system have satisfying effects in treatment of degenerative lumbar spinal disorder .Non-fusion fixation can reduce adjacent segment degenera-tion.