同节段出口根减压对严重腰椎间盘脱出症治疗的影响

The effect of exiting nerve roots depression on the therapy of prolapse of lumbar intervertebral disc

目的研究同节段出口根减压对严重腰椎间盘脱出手术效果的影响,探讨同节段出口根减压与腰椎术后邻近节段退变的关系。方法选择70例严重腰椎间盘脱出症患者,将其随机分为两组,所有患者均行腰椎后路全椎板减压植骨融合内固定术。实验组:术中对双侧同节段出口根进行充分减压;对照组:未对同节段出口根进行减压。对两组进行JOA评分,测量术后腰椎动力位像上手术邻近节段椎间隙高度和椎间活动度。结果实验组与对照组JOA改善指数比较有统计学意义(P<0.05),两组间术前与术后椎间高度差及邻近节段椎间活动度变化比较无明显统计学意义(P>0.05)。结论对于严重腰椎间盘脱出症患者行腰椎后路椎间融合术+同节段出口根减压术,可以有效缓解腰腿痛症状,并且术后6个月内不会增加邻近节段退变的危险。

Objective To explore the effect of exiting nerve roots depresssion on the operative effect of prolapse of lumbar intervertebral disc,and investigate the the Relationship between exiting nerve roots depresssion and adjacent segment degeneration after lumbar operation. Methods 70 patients with prolapse of lumbar intervertebral disc in our hospitial were selected,And they were randomly devided into experimental group and control group,The patients of two grous were treated with posterior lumbar intebody fusion（PLIF）. Experimental group ：Decompressed for the two sides of exiting nerve roots sufficiently. Control group：Without decompressed for the exiting nerve roots. E- valuate the the twos groups with JOA scores. The disc height and lumbar motility of adjacent seg- ment were mesured on the lumbar X ray images. Results There was significant difference of JOA improvement index between the two groups （P〈0.05）. There was no significant difference of intervertebral height and lumbar motility of adjacent segment between the two groups （P〉0.05）. Conclusion The patients with prolapse of lumbar intervertebral disc treated with PLIF and exiting nerve roots depresssion can relief symptom effectively.and will not increase the risk of adjacent segment degeneration in 6 months after operation.