后路椎体间融合联合后外侧融合术治疗腰椎退行性疾病的临床研究

Clinical study of posterior lumbar interbody fusion combined with postlateral fusion in the treatment of lumbar degenerative disease

目的观察单纯后路椎体间融合术与后路椎体间融合联合后外侧融合术治疗腰椎退行性疾病的疗效。方法选择本院收治的75例腰椎退行性疾病患者,其中35例患者行单纯后路椎体间融合术作为对照组,40例患者行后路椎体间融合联合后外侧融合术作为联合组,记录两组患者术中出血量、术后48h内引流量、术后切口疼痛程度及并发症发生情况。结果所有患者均获得随访。两组术中出血量、手术时间、并发症发生率、住院天数比较,差异均无统计学意义(P>0.05);两组48h内伤口引流量、术后3d切口疼痛VAS评分、住院费用比较,差异有统计学意义(P<0.05)。两组患者的临床疗效、融合率差异无统计学意义(P>0.05)。结论联用或不联用后外侧融合术对椎弓根内固定下后路椎体间融合治疗腰椎退行性疾病的短期临床疗效、融合率无明显影响,且后路椎间融合联合后外侧融合术增加了住院费用及时间。

Objective To observe the efficacy of posterior lumbar interbody fusion and posterior lumbar interbody fu sion combined with postlateral fusion in the treatment of lumbar degenerative disease.Methods 75 patients with lumbar degenerative disease in our hospital were selected.in which 35 patients underwent posterior lumbar interbody fusion as control group,and 40 patients underwent posterior lumbar interbody fusion combined with post-lateral fusion as alliance group.The blood loss,drainage within 48 h,postoperative incision pain and complications of the two groups were recorded.Results All the patients were followed up.The differences of blood loss,operative time,complication rate,the number of days of hospitalization between two groups were not statistically significant ( P>0.05).The differences of wound drainage within 48 h,3 d incision pain VAS score and hospital costs were statistically significant ( P<0.05).The clinical efficacy and the fusion rate of the two groups were not significant difference ( P>0.05).Conclusion Short-term clinical efficacy and fusion rate of posterior lumbar interbody fusion pedicle screw fixation combined with or not asso ciated with post-lateral fusion for the treatment of degenerative diseases had no significant effect,and posterior lumbar interbody fusion combined with post-lateral fusion increases hospital costs and time.