单侧椎弓根螺钉与双侧椎弓根螺钉在腰椎融合手术中的疗效比较

【作者】 李悦；

【导师】 姜晓幸； 冯振洲；

【作者基本信息】 复旦大学 ， 外科学， 2008， 硕士

【摘要】 目的:对比研究旁正中切口下单侧椎弓根螺钉固定单侧椎板切除双侧减压TLIF手术与双侧椎弓根螺钉固定双侧椎板切除减压TLIF手术的疗效。方法:自2007年5月15日至2007年12月15日行腰椎后路融合手术20例,由随机表将患者分入单侧手术组与双侧手术组,单侧手术组(A组)8例,其中男3例,女5例,平均年龄51.75岁。双侧手术组(B组)12例,其中男6例,女6例,平均年龄51.92岁。使用Oswestry评分,JOA评分,VAPS视觉类比评分对两组患者术前症状评分及术后疗效参数进行比较,并对两组的手术时间,出血量及融合率进行比较。结果:单侧组与双侧组随访3—6月,两组术前与术后三个月的Oswestry评分,JOA评分,VAPS视觉类比评分有统计学差异(p＜0.05),A组术后的Oswestry评分,JOA评分,VAPS视觉类比评分与B组无统计学差异(p＞0.05),两组手术时间有统计学差异,A组短于B组,两组出血量无统计学差异,两组术后三个月的融合率为100%,两组均无术后并发症。结论:旁正中切口下单侧椎弓根螺钉固定单侧椎板切除双侧减压TLIF手术与双侧椎弓根螺钉固定双侧椎板切除减压TLIF手术均有疗效,其疗效无统计学差异。更多还原

【Abstract】 Purpose: To compare the clinical effects of bilateral decompression through unilateral laminectomy by paramedian incision using unilateral pedicle screw instrumentation and bilateral laminectomy for decompression by bilateral paramedian incision using bilateral pedicle screw instrumentation in transforaminal posterior lumbar interbody fusion(TLIF).Methods: From 5/15/2007 to 12/15/2007, 20 patients had underwent TLIF surgery, we arranged the patients to unilateral group (Group A) or bilateral group (Group B) by randomize. Among Group A, there are 3 males and 5 females, 5 in L45 and 3 in L5S1. Their mean age is 51. 75 years old. Among Group B, there are 6 males and 6 females, 11 in L45 and 1 in L5S1. Their mean age is 51. 92 years old. We compare the clinical effects between Group A and Group B by using Oswestry Disability Index, JOA Index and VAPS Index. We also compare the operating time, blood loss and fusion rates between them.Results: The follow-up time is 3 months to 6 months. The ODI, JOA and VAPS indexes of the patients showed significant differences between preoperative and 3 months after operative among Group A and Group B(p<0.05). The ODI, JOA and VAPS indexes of the patient which collected at 6 weeks, 3 months 6 months showed no significant differences between Group A and Group B (p>0.05) . The operating time of Group A is shorter than Group B, which showed significant differences. (p<0.05) The blood loss showed no significant differences between Group A and Group B. The post operation fusion rates at 3 months of both groups is 100%. There are no postoperative complications of both groups.Conclusions: Both of the bilateral decompression through unilateral laminectomy by paramedian incision using unilateral pedicle screw instrumentation and bilateral laminectomy for decompression by bilateral paramedian incision using bilateral pedicle screw instrumentation had significant effects in transforaminal posterior lumbar interbody fusion. There are no significant differences between them.更多还原