单侧椎弓根固定联合单枚椎间融合器经椎间孔椎体间融合术后对侧腰骶部疼痛(英文)

Postoperative back pain of opposite lumbosacral area attribute to unilateral fixation with diagonal cage-instrumented transforaminal lumbar interbody fusion

[目的]探讨单侧椎弓根固定联合单枚椎间融合器经椎间孔椎体间融合术后对侧腰部疼痛原因及发生率。[方法]2008年10月～2011年10月,30例资料完整的患者(男16例,女14例,年龄40～56岁)行单侧椎弓根固定联合单枚椎间融合器行经椎间孔椎体间融合术。分析术前及术后ODI评分及VSA评分,通过术后影像学表现分析椎间高度及对侧关节突情况。[结果]术前及术后3、6、12个月ODI评分、VSA评分有统计学意义(P<0.05)。融合率为92%,临床满意率为89%,3例患者术后出现对侧腰骶部疼痛。[结论]单侧固定术后椎间高度恢复不对称及对侧关节紊乱应引起重视,应严格限制手术适应证。

[ Objective] The purpose of this study was to explore the possible causes and incidence of the postoperative back pain in the opposite lumbosacral area. [ Methods] Form October 2008 to October 2011, thirty consecutive patients （16 men and 14 women with age ranged from 40 to 56 years） underwent diagonal cage-instrumented lumbar interbody fusion with unilateral fixation. Pre-and postoperative scores measured by Oswestry Disability Index （ ODI）, Visual Analog Scale （VAS） were ana- lyzed. Fusion status, condition of intervertebral height and oposite facets were investigated with X-ray and CT scans. [ Rusults ] Oswestry Disability Index （ ODI）, Visual Analog Scale （VAS） showed statistical significance between perioperation and 3 months,6 months, 12 months postoperatively（P 〈 0.05）. The fusion rates were 92%, The clinical results were 89% satisfacto- ry,three patients complained postoperative back pain in the opposite lumbosacral area. [ Conclusion] Due attention should pay to the postoperative back pain arised from the restore intervertebral height asymmetryly and the oposite facets dsyfunction. The operation indications must be strictly defined and long-term clinical studies are required.