【摘要】 目的:探讨单、双侧椎弓根螺钉内固定椎间融合治疗单节段单侧症状腰椎间盘突出症的临床效果。方法:分析自2014年1月-2016年6月采用腰椎椎弓根螺钉内固定加椎间融合器植入术治疗的80例腰椎间盘突出症患者。按内固定方式分为A组和B组,每组患者40例,其中男41例,女39例,年龄23~57岁,平均年龄43.3岁。影像学资料显示L3-4:8例,L4-5:42例,L5S1:30例。对手术时间、术中出血量、材料费用、住院费用、JOA评分及椎间融合率进行对比分析,评价两种术式的临床治疗效果。结果:两组间手术时间、术中出血量、材料费用、住院费用等指标进行比较差异有统计学意义(P<0.05);两组间JOA评分、优良率及椎间融合率比较无差异;两组内术前术后JOA评分比较有差异(P<0.05)。结论:采用单、双侧椎弓根螺钉内固定椎间融合治疗单节段单侧症状腰椎间盘突出症均可获得满意的临床效果,单侧固定在手术时间、术中出血量、材料费、住院费用等方面有明显优势。更多还原

【Abstract】 Objective: To investigate the clinical effect of single and bilateral pedicle screw fixation combined with interbody fusion cage in the treatment of Single segment unilateral lumbar disc herniation.Methods:From January 2014 to June 2016,80 cases of lumbar interbody fusion cage implantation for the treatment of lumbar disc herniation patients were treated by using lumbar pedicle screw fixation.The patients were divided into Group A: unilateral pedicle screw fixation and interbody fusion cage implantation and Group B: bilateral pedicle screw fixation and interbody fusion cage implantation group. Each group of patients were 40 cases. 41 cases were male and 39 were female, aged 23 to 57 years,43.3years in average. All cases were diagnosed as lumbar disc herniation and need surgical treatment with obvious symptoms of leg pain. CT,MR and other imaging data show L3-4intervertebral disc herniation in 8 cases,L4-5lumbar disc herniation in 42 cases and L5S1 in 30 cases. We respectively analyzed the clinical effect of single and bilateral pedicle screw fixation combined with interbody fusion cage according to the operation time,blood loss,the cost of materials and hospitalization and JOA scores.Results:There were significant differences between the two groups in the time of operation,the amount of intraoperative blood loss,the cost of materials and the cost of hospitalization(P<0.05).There was no significant difference between the two groups in preoperative and postoperative JOA score,excellent rate and interbody fusion rate(P>0.05).Conclusion:The clinical effect of single lumbar pedicle screw fixation and interbody fusion cage implantation for the treatment of lumbar disc herniation is as effective as bilateral pedicle screw fixation. There are obvious advantages in unilateral fixation group in the operation time,bleeding volume during operation,the cost of materials and hospitalization.更多还原