【摘要】 背景:对于仅有一侧腰腿痛的腰椎间盘突出症需手术治疗的患者,常见的治疗方法包括腰椎椎板开窗减压和全椎板切除加压加双侧椎弓根螺钉内固定,但其治疗效果均不理想。目的:探讨单侧椎弓根螺钉内固定结合单枚腰椎椎间融合器置入治疗出现一侧腰腿痛症状腰椎间盘突出症的可行性和临床效果。方法:新疆石河子人民医院对40例一侧腰腿疼痛为主要症状的腰椎间盘突出症患者行单枚腰椎椎间融合器置入+单侧椎弓根螺钉内固定治疗。治疗前后按日本骨科学会(JOA)1984年制定的腰腿痛疗效标准分别对患者进行治疗前和治疗后的随访评分,计算治疗后的改善率和优良率;并按Suk标准评定椎间融合率。结果与结论:40例患者均获得随访,时间6-60个月。切口均一期愈合,无切口感染。治疗后6个月JOA评分显著高于治疗前(P<0.05),优良率为88%。按Suk标准评定,38例患者影像学资料符合确认植骨融合或可能融合,椎间融合率为95%。剩余2例患者在治疗后9个月随访时达到上述标准。提示单枚椎间融合器置入加单侧腰椎椎弓根螺钉内固定治疗仅有一侧腰腿痛症状的腰椎间盘突出症可获得满意的效果。更多还原

【Abstract】 BACKGROUND: As for patients with one-side backleg pain who were candidates for surgery treatment of lumbar intervertebral disc herniation, the common treatment includes lumbar vertebral plate opening and decompression,and laminectomy in combination with compression and bilateral pedicle screw fixation. However, these therapeutic approaches are not satisfactory.OBJECTIVE: To explore the feasibility and efficiency of single-side lumbar interbody fusion and unilateral pedicle screw fixation for treatment of lumbar intervertebral disc herniation patients with one-side backleg pain.METHODS: Forty patients with single-side lumbar disc herniation, suffering from unilateral backleg pain, were recruited from Shihezi People’s Hospital, China and were treated with single-side lumbar interbody fusion and unilateral pedicle screw internal fixation. The neurological function of patients was assayed using Japanese Orthopaedic Association score system before and after treatment, the improvement rate and excellent/good rate were calculated. Suk criterion was used to determine fusion status.RESULTS AND CONCLUSION: The mean follow-up period for 40 patients was ranging from 6 months to60 months. All incisions healed well, with no infection. The Japanese Orthopaedic Association score after6 months of treatment was significantly higher than that before treatment(P < 0.05), with the excellent and good rate up to 88%. According to Suk criterion, 38 patients achieved bone graft fusion or possible fusion, withinterbody fusion rate 95%, as revealed by radiographic and CT evidence. The remaining two patients were detected fusion at9 months after treatment. Our findings indicate that, single-cage lumbar interbody fusion combined with single-side pedicle screw fixation is the feasible surgical technique and provides satisfactory effects in treating single-side lumbar disc herniation.更多还原