后路减压椎弓根钉内固定合并椎间隙植骨融合治疗腰椎间盘突出征

目的通过回顾、对照、经验总结探讨后路减压椎弓根钉内固定合并椎间隙植骨融合治疗腰椎间盘突出征的疗效及其治疗指征。方法随机抽取本院2004年7月~2006年6月应用后路减压手术治疗腰椎间盘突出征患者200例。根据不同手术方法将患者分为2组,其中实验组70例应用椎弓根钉内固定合并椎间隙植骨融合治疗,对照组130例单纯后路减压全椎板或半椎板摘除椎间盘手术治疗。比较2组手术时间、住院费用、术中出血量、手术前后及末次随访时椎间隙高度,术后下床活动时间,术后残留腰痛症状,术后复发情况。结果试验组与对照组手术切口长度无明显差异,手术时间、住院费用、术中出血量,手术前后及末次随访时椎间隙高度,术后下床活动时间,术后残留腰痛症状,术后复发情况两组之间比较有统计学差异(P<0.05)。结论后路减压椎弓根钉内固定合并椎间隙植骨融合治疗腰椎间盘突出征安全可靠。术后椎间隙高度不丢失,残留腰痛症状少,疗效确切。年龄、经济因素对手术的影响较大;相临节段椎间盘加速退变目前尚需要继续研究。

The treatment of lumbar disc herniation using pedicle screw fixation with the lumbar interbody fusion from the Posterior decompression

Objective To review,control,sum up the efficacy of treatment and the treatment indications of lumbar disc herniation using pedicle screw fixation with the lumbar interbody fusion from the posterior decompression.Method Randomly selected 200 cases from July 2004 to June 2006 use posterior decompression surgery for lumbar disc herniation in our hospital.According to different surgical methods they were divided into two groups: one group using pedicle screw fixation with the lumbar interbody fusion of 70 cases,the control group simply posterior decompression laminectomy or semi-laminectomy disc surgery for removal of 130 cases.Comparing the two groups the surgery time, the hospital fees,the volume of blood loss,the intervertebral space height of the before and after surgery also the end of follow-up,the time of getting out of bed after surgery,the pain of residual symptoms,and the recurrent situation.Results The test group and the control group was no significant difference between the surgical incision length,but more significant difference(P<0.05) between the surgery time,the hospital fees,the volume of blood loss,the intervertebral space height of the before and after surgery also the end of follow-up,the time of get out of bed after surgery,the pain of residual symptoms,and the recurrent situation.Conclusions The treatment of lumbar disc herniation using pedicle screw fixation with the lumbar interbody fusion from the Posterior decompression is safe and reliable.The height of intervertebral space no loss,less residual pain symptoms,the treatment is effective.Age and economic factors are strongy affecting the operation.The Provisional disc degeneration accelerating needs to be further studied.