半椎板切除椎间植骨融合治疗退行性腰椎不稳疗效对比

Analysis of clinical effective for the treatment of degenerative lumbar spine instability hemilaminectomy

目的分析半椎板切除椎间植骨融合治疗退行性腰椎不稳临床疗效。方法应用半椎板切除、间盘摘除、后路椎间植骨融合、椎弓根钉内固定术治疗退行性腰椎不稳患者8例,按JOA评分标准进行评定,影像学观察术后椎间隙高度恢复情况,同全椎板切除组术后疗效进行比较。结果术后8例均获随访,时间6个月-3年,平均21个月,优6例(75%),良2例(25%),优良率100%;全椎板切除术后9例获随访,优3例(33.3%),良2例(22.2%),可2例(22.2%),差2例(22.2%),优良率55.6%;采用Wilconxon秩和检验,P<0.05,有显著性差异。结论半椎板切除、后路椎间植骨融合椎弓根钉内固定术治疗退变性腰椎不稳,临床疗效满意。

Objective To analysis the postoperative effects of degenerative lumbar spine instability by hemilaminectomy and intervertebrae with bone graft fusion. Methods Hemilamineetomy and discectomy for lumbar disc herniation and internal fixation with bone graft fusion for treatment of 8 cases which diagnosed degenerative lumbar spine instability. The clinical effects were evaluated by JOA standard and the post - operative height resumption of intervertebrae spaces, and compare the postoperative effect with total laminectomy were observed. Results All of the 8 cases were followed up from 6 months to 3 years. The post - operative excellent and good rates were 100%. 9 eases were followed up by total laminectomy after operative. Excellent and good rates were 55.5%. There was significant difference between two groups according to the Wilconxon rank sum test （ P 〈 0.05 ）. Conclusion Hemilaminectomy and internal fixation with bone graft fusion is a kind of reliable and effective surgical procedure for the treatment of degenerative lumbar spine instability.