单侧和双侧内固定联合髓核摘除椎间融合术治疗腰椎间盘突出症的效果比较

Effect comparison of unilateral and bilateral internal fixation combined with nucleus pulposus removal of intervertebral fusion operation treating lumbar disc herniation

目的：比较单侧和双侧内固定联合髓核摘除椎间融合术治疗腰椎间盘突出症的效果。方法回顾性分析本院2010年1月~2012年12月行髓核摘除椎间融合固定术治疗的49例单间隙腰椎间盘突出症患者。依据固定方式将患者分为单侧内固定组和双侧内固定组。比较两组的手术用时、术中出血量、住院时间、住院费用、疼痛VAS评分、Oswestry功能障碍指数（ODI）评分、融合率和并发症发生率等。结果两组术前的VAS、ODI评分比较差异无统计学意义（P〉0.05），末次随访时，两组的VAS、ODI评分均显著降低（P〈0.05），但两组比较差异无统计学意义（P〉0.05）。单侧组的手术用时明显短于双侧内固定组，术中出血量明显少于双侧内固定组，住院费用明显低于双侧内固定组（P〈0.05）。两组的融合率和并发症率发生率比较差异无统计学意义（P〉0.05）。结论单侧与双侧内固定椎间融合对单间隙腰椎间盘突出症的治疗效果相当，但手术用时较短、术中出血量较少、住院费用较低。

Objective To compare the effect of unilateral and bilateral internal fixation combined with nucleus pulposus removal of intervertebral fusion operation treating lumbar disc herniation. Methods 49 cases with single gap lumbar disc herniation treated with nucleus pulposus removal of intervertebral fusion operation from January 2010 to December 2012 in our hospital were retrospectively analyzed. Based the fixed way,patients were divided into unilateral fixation group and bilateral fixation group.The surgery time,intraoperative bleeding amount,hospital stay,hospital expense,VAS score of pain,Oswestry disability index （ODI） score,fusion rate and incidence rate of complication between two groups was compared respectively. Results Before operation,there was no statistical difference of VAS,ODI score between two groups （P〉0.05）,and VAS,ODI score of two groups was significantly reduced respectively at the last follow-up （P〈0.05）, but there was no statistical difference between two groups （P〉0.05）.The surgery time in unilateral fixation group was ob-viously shorter than that of bilateral fixation group,intraoperative bleeding amount in unilateral fixation group was obvi-ously less than that of bilateral fixation group,hospital expense in unilateral fixation group was obviously lower than that of bilateral fixation group （P〈0.05）.There was no statistical difference of fusion rate and incidence rate of complication between two groups （P〉0.05）. Conclusion The curative efficacy of unilateral and bilateral internal fixation interverte-bral fusion for single gap lumbar disc herniation is almost the same,but unilateral internal fixation has shorter operation time,less intraoperative bleeding amount and lower hospital expense.