腰椎内固定治疗腰椎间盘突出症并腰椎退变不稳的临床观察

Clinical observation of lumbar internal fixation in the treatment of lumbar disc herniation and degenerative lumbar instability

目的评价腰椎间盘摘除、腰椎内固定术治疗腰椎间盘突出症并腰椎退变不稳的临床疗效。方法对68例腰椎间盘突出症并腰椎退变不稳患者采用腰椎间盘摘除、腰椎弓根钉内固定和cage椎间植骨融合术治疗，随访2—3年，按Macnab标准评价疗效。结果68例患者手术后临床疗效评价，优38例、良25例、可5例，术后2年时进行影像学检查发现椎间植骨融合骨性愈合68例，所有椎弓根钉均无松动，cage未见下沉移位，患者腰腿疼痛症状均有改善。结论腰椎间盘摘除、腰椎弓根钉内固定和cage椎间植骨融合术是治疗腰椎退变不稳并腰椎间盘突出症的一种安全而有效的手术方法，术中的规范操作是保证疗效的重要因素。

Objective To evaluate the clinical effect of lumbar discectomy,lumbar internal fixation in the treatment of lumbar disc herniation and degenerative lumbar instability. Methods 68 cases with lumbar disc herniation and degenerative lumbar instability were treated by lumbar discectomy,lumbar pedicle screw fixation and interbody fusion with cage. The patients were followed up for 2-3 years,the clinical efficacy was evaluated according to Macnab standard. Results The clinical evaluation of 68 patients after operation,38 cases were excellent,good in 25 cases,fair in 5 cases. 2 years after operation, the results of imaging examination showed interbody fusion and bone healing in 68 cases, all pedicle screws had no loosening,no cage subsidence dis- placement,patients＂ back and leg pain symptoms were improved. Conclusion Lumbar discectomy,lumbar pediele screw fixation and cage interbody fusion is a safe and effective operation method for degenerative lumbar instability and lumbar intervertebral disc herniation,the standard operation is an important factor to ensure the therapeutic efficacy.