复发性腰椎间盘突出症的手术治疗

Surgical treatment of recurrent lumbar disc herniation

目的探讨椎管减压、Cage椎间融合、椎弓根螺钉内固定术治疗复发性腰椎间盘突出症的临床效果。方法 2008年1月至2012年3月对收治的20例复发性腰椎间盘突出症患者行椎管减压、Cage椎间融合、椎弓根螺钉内固定术治疗。使用日本骨科协会评分(JOA)系统评估术前及术后腰椎功能,按MacNab标准评估患者术后满意度,并进行统计学分析。结果术后随访4～46个月,平均29.6个月。JOA术前(13.450±4.617)分,术后3个月(21.350±3.746)分,二者比较,差异有统计学意义(P<0.01)。按MacNab标准评估患者术后满意度,优13例(65%),良4例(20%),中2例(10%),差1例(5%),优良率为85%。结论椎管减压、Cage椎间融合、椎弓根螺钉内固定术治疗复发性腰椎间盘突出症疗效满意。

Objective To study the clinical effect of posterior spinal canal decompression,vertebral Cage interbody fusion and transpedicular screw fixation for recurrent lumbar disc herniation（RLDH）.Methods 20 cases of RLDH were performed posterior spinal canal decompression,vertebral Cage interbody fusion and transpedicular screw fixation from January 2008 to March 2012.The lumbar vertebral function before and after operation were evaluated by JOA score and the patient postoperative satisfaction was evaluated by the MacNab′s criteria.The results were analyzed statistically.Results All patients were followed up for 6-36 months with an average of 29.6 months.The JOA score was 13.450±4.617 before surgery and 21.350±3.746 in postopertative 3 months,the difference showing statistical significance（P0.01）.According to the MacNab′s criteria for evaluating the postoperative satisfaction,13 cases（65%） were excellent,4 cases（20%）were good,2 cases（10%）were fair and 1 case（5%） was poor.The excellent and good rate was 85%.Conclusion Posterior spinal canal decompression,vertebral Cage interbody fusion and transpedicular screw fixation have satisfactory effects in treating RLDH.