单侧椎体间融合和后外侧融合治疗复发性腰椎间盘突出症的临床分析

Clinical analysis of unilateral lumbar interbody fusion and posterolateral lumbar fusion for recurrent lumbar disc herniation

目的探讨单侧椎体间融合和后外侧融合治疗复发性腰椎间盘突出症的临床效果。方法将2007年3月至2010年9月在我科治疗的54例复发性腰椎间盘突出症患者分成两组,对照组27例采用双侧椎体间融合和后外侧融合治疗,研究组27例则采用单侧椎体间融合和后外侧融合治疗,治疗后观察并随访上述两组患者的相关临床资料。结果在手术出血量、手术时间、住院天数、医疗费用等方面,研究组较对照组低,具有统计学差异(P<0.05);在VAS与ODI评分方面,研究组与对照组比较无统计学差异(P>0.05),但两组患者组内术后与术前相比较均具有显著的统计学差异(P<0.05);两组患者治疗后的临床疗效通过Mac-Nab疗效标准进行评估,相比较没有统计学差异(P>0.05)。结论单侧椎体间融合和后外侧融合治疗复发性腰椎间盘突出症疗效显著,具有手术出血量少、手术时间短、住院天数少、节约医疗费用等优势。

Objective To investigate the clinical efficacy of unilateral lumbar interbody fusion and posterolateral lumbar fusion for the recurrent lumbar disc herniation.Methods Totally 54 patients with recurrent lumbar disc herniation were selected and randomly divided into control group and study group（n=27）.The patients in control group were treated with bilateral fixation while those in study group were received unilateral fixation.The clinical data of the two groups were compared after the treatment.Results The blood loss,operation time,hospitalization duration and medical cost in study group were lower than those in control group（P0.05）.There was no significant difference in the visual analog scale（VAS）,oswestry disabilityindex（ODI） score and the total effective rate between the two groups（P0.05）,however,the VAS,ODI and total effective rate were statistically different before and after treatment（P0.05）.The clinical efficacy was not statistically different between the two groups after the treatment according to MacNab criteria.Conclusion The therapy of unilateral lumbar interbody fusion combined with posterolateral lumbar fusion is effective for the recurrent lumbar disc herniation,meanwhile it is with the advantages of fewer blood loss,shorter hospitalization duration and less medical cost.