椎间融合器联合椎弓根螺钉系统内固定治疗腰椎间盘突出伴椎管狭窄症

Combined intervertebral fusion device with pedicle screw internal fixation for the treatment of lumbar disc herniation with spinal stenosis

目的：探讨椎间融合器联合椎弓根螺钉系统内固定治疗腰椎间盘突出,伴椎管狭窄症的疗效。方法：在2005年1月~2009年2月期间对18例腰椎间盘突出,伴椎管狭窄症的患者采用了经椎弓根固定,全椎板切除椎管减压、单枚或双枚椎间融合器植入融合术。并随机抽取18例同期单纯椎板切除椎管减压及髓核摘除的同种疾病的病人作为对照组,采用日本骨科学会（JOA）腰腿痛疗效评分标准（29分法）,根据术后改善率评价,对结果进行统计学分析。结果：术后随访6~24个月,末次随访时JOA评分改善率,内固定组为73.27%±14.75%,非内固定组为47.33%±11.86%。两组数据经t检验（t=5.815,p〈0.05）,有统计学差异。结论：全椎板切除椎管减压、椎间融合器联合椎弓根螺钉系统内固定治疗腰椎间盘突出,伴椎管狭窄症疗效显著,较传统方法有一定优越性,保持椎间隙高度,腰痛缓解率高,且较少并发症,但内固定组费用较高,患者负担较大。

Objective：To discuss the efficacy of Combined intervertebral fusion device with pedicle screw internal fixation method in treatment of lumbar disc herniation with spinal stenosis.Method：From January 2005 to February 2009,Observations has been made in 18 patients suffered from lumbar disc herniation with spinal stenosis after treatment by Combined intervertebral fusion device with pedicle screw internal fixation method for their effective rate and status of rehabilitation.The other 18 cases were treated with limited laminectomy decompression.The clinical outcome at preoperation and follow-up was analyzed by Japanese Orthopaedic Association（JOA） score.The results were put into statical analysis.Results：All patients were followed up for avcragcd 18months（range,6 months to 24 months）.The improve rate of JOA score at final followed up for each group was 73.27%±14.75%,47.33%±11.86% respectively.Which showed statistical difference among two groups（t=5.815,p0.05）.Conclusion：The results of Combined intervertebral fusion device with pedicle screw internal fixation method in treatment of lumbar disc herniation with spinal stenosis is more satisfactory with significant efficacy and less complication than the traditional methods.