前路减压植骨内固定治疗胸腰段椎间盘突出症

Thoracolumbar protrusion of the intervertebral disc treated with anterior decompression and fusion

目的探讨前路减压植骨内固定治疗胸腰段椎间盘突出症疗效。方法对18例胸腰段椎间盘突出症患者行左侧经胸膜(腹膜)外入路,截取合适长度肋骨嵌插植入于椎体间隙并行内固定。结果患者均获随访,时间1～3年。术后9个月时X线片复查植骨均牢固融合;无内固定松动、植骨块脱出、塌陷,无内固定钉、板(棒)断裂。术后1年神经功能恢复情况:A级1例恢复至B级,B级3例均恢复至C级,C级5例均恢复至D级,D级6例恢复至E级。结论前路手术治疗胸腰段椎间盘突出症术野清晰,减压彻底,植骨可靠,神经功能明显改善。

Objective To investigate the efficacy of thoracolumbar protrusion of intervertebral disc treated with anteri- or decompression and fusion. Methods Eighteen patients with thoracolumbar protrusion of the intervertebral disc were treated by left pleural （the peritoneum） surgical approach, intercepting the right length frame embedded in the vertebral body clearance and fixation. Results All the patients were followed up for one to three years. After 9 months, all got solid bone graft fusion; No internal fixation loosening, graft block emergence, collapse screw, plate （bar） breakage were found with X ray review. After one year, nerve function recovery： 1 case of A level recovered to grade B, 3 cases of B level recovered to grade C, 5 cases of C grade recovered to grade D, 6 cases of D level recovered to grade E. Conclusions The treatment of thoracolumbar protrusion of the intervertebral disc with anterior decompress is effective and safe, and nerve function is obviously improved.