单侧钉棒固定加椎间融合治疗旁侧型腰椎间盘突出症疗效观察

Clinical observation of single screw-rod system fixation and intervertebral fusion for the treatment of lateral lumbar disc herniation

目的探讨单侧椎弓根钉棒固定结合单枚cage椎间融合治疗旁侧型腰椎间盘突出症的临床疗效。方法应用后路钉棒固定加单枚cage椎间融合治疗88例旁侧型腰椎间盘突出症患者，其中单侧钉棒固定46例，双侧钉棒固定42例。在术前、术后3个月和末次随访时分别按JOA评分和疼痛视觉模拟评分（VAS）评价临床疗效。结果患者均获随访，时间12-19（14．3±1．6）个月。JOA和VAS评分：术前、术后及末次随访时两组间比较差异均无统计学意义（P〉0．05），两组术后、末次随访与术前比较差异均有统计学意义（P〈0．01），两组末次随访与术后比较差异均无统计学意义（P〉0．05）。结论单侧椎弓根钉棒固定与双侧钉棒固定加椎间融合治疗旁侧型腰椎间盘突出症具有相同的临床疗效，而单侧固定具有手术时间短、出血少、损伤小、器械费用低等优点，是治疗旁侧型腰椎间盘突出症理想手术方法。

Objective To evaluate the efficacy of using single screw-rod system and interbody fusion in the treatment of lateral lumbar disc herniation. Methods 88 patients with lateral lumbar disc herniation were treated by either internal fixation with unilateral （46 cases） or bilateral （42 cases） transpedicle screws combined with interbody fusion. The clinical evaluations of treatment were assessed by both of JOA score and visual analog scale （VAS） in the period before surgery, three months postoperation and last follow-up, Results All patients were followed up for 12 - 19 （ 14. 3 ± 1.6） months. No significant statistical differences of JOA scores and VAS were found between groups of preoperative, three months postoperation and last follow-up （P 〉 0.05 ）, there were significant differences between preoperative group and the other two groups （P 〈 o. Ol ）, no significant statistical differences was found between last follow-up group and three months postoperation group （P 〉 0. 05）. Conclusions Similar clinical effects in the treatment of lateral lumbar disc herniation are found in both of internal fixation with unilateral transpedicle screws and bilateral transpedicle screws combined with interbody fusion, but the former has several advantages including short operating time, less bleeding and less damages, which makes it to be an ideal operation method.