RSS椎弓根钉内固定结合植骨融合治疗腰椎间盘突出症的有效性探究

Research of effectiveness on RSS pedicle screw combined with fusion in the treatment of lumbar disc herniation

目的：探讨RSS椎弓根钉内固定结合植骨融合治疗腰椎间盘突出症伴腰椎不稳的临床效果。方法将本院2011年9月~2013年9月收治的44例腰椎间盘突出症伴腰椎不稳患者按不同手术治疗方案随机分为对照组21例和观察组23例，对照组采用髓核摘除＋经后路关节突单纯植骨融合手术治疗，观察组采用RSS椎弓根钉内固定＋植骨融合手术治疗，比较两组的围术期情况、JOA评分、植骨融合情况。结果两组的手术耗时、术中出血量及住院时间比较差异无统计学意义（P〉0.05）。两组术后6个月的JOA评分均明显高于术前（P〈0.05）；观察组术后6个月的JOA评分高于对照组（P〈0.05）。两组植骨融合成功率比较差异有统计学意义（P〈0.05）。结论RSS椎弓根钉内固定结合植骨融合治疗腰椎间盘突出症伴腰椎不稳具有植骨融合率高、远期恢复效果显著等优点，值得临床推广应用。

Objective To investigate the clinical effect of RSS pedicle screw combined with fusion in the treatment of lumbar disc herniation complicated with lumbar instability. Methods 44 cases of patients with lumbar disc herniation complicated with lumbar instability in our hospital from September 2011 to September 2013 were randomly divided into control group （21 cases） and observation group （23 cases）.Nucleus pulposus combined with processus posterior bone grafting were used in control group,RSS pedicle screw combined with fusion were used in observation group.The periop-erative situation,JOA score,bone graft fusion of two groups was compared respectively. Results The operation time, bleeding volume and hospitalization time in two groups was compared respectively,with no statistical difference（P〉0.05）. After operation of 6 months,JOA score in two groups was significantly higher than that before operation （P〈0.05）.After operation of 6 months,JOA score in observation group was significantly higher than that in control group （P〈0.05）.The success rate of fusion in two groups was compared,with statistical difference （P〈0.05）. Conclusion RSS pedicle screw combined with fusion in the treatment of lumbar disc herniation complicated with lumbar instability has many advan-tages such as high success rate of fusion and significant forward-recovery effect,it is worthy of clinical promotion and application.