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 internal fixation on lumbar vertebra treatment of lumbar disc herniation combined with instable lumbar vertebral degeneration

目的探讨腰椎内固定治疗腰椎间盘突出症并腰椎退变不稳的临床疗效。方法将2013年4月~2014年4月在我院骨科治疗的120例腰椎间盘突出症并腰椎退变不稳的患者随机分为两组,对照组采用传统无固定手术方法,观察组采用腰椎间盘摘除、腰椎弓根钉内固定、椎间植骨融合术治疗的方法,比较两组患者的治疗效果、植骨融合情况、疼痛情况、腰椎功能及不良反应。结果观察组优良率为95.00%,骨融合率为95.00%,对照组优良率为81.67%,骨融合率为85.00%,差异有统计学意义（P〈0.05）;两组术后VAS、ODI评分均较术前显著改善,但观察组较对照组改善明显,差异有统计学意义（P〈0.05）;两组不良反应发生率均较低（P〉0.05）。结论腰椎内固定治疗腰椎间盘突出症并腰椎退变不稳治疗效果理想,恢复率高,失败率低,安全性高,有积极的临床意义。

Objective To study the clinical effect of internal fixation on lumbar vertebra in the treatment of lumbar disc herniation combined with instable lumbar vertebral degeneration. Methods 120 patients with lumbar disc herniation combined with instable lumbar vertebral degeneration, who were treated in orthopaedics department of our hospital from April 2013 to April 2014, were randomly divided into control group who were treated with traditional non-fixation operation and observation group who were treated with the methods of lumbar diskectomy, lumbar pedicle screw fixation, intervertebral bone graft fusion. To compare the treatment effect, the situation of bone graft fusion, the pain situation, the lumbar function, and the adverse reaction between the two groups. Results The excellent and good rate and the bone fusion rate were 95.00% and 95.00% in observation group, while which were 81.67% and 85.00%in control group, the differences was statically significant（P〈0.05）. The VAS and ODI scores after operation had more significantly improvement than before operation, while which in observation group had more significantly improvement than in control group, the differences was statically significant（P 〈 0.05）. The incidence of adverse reactions of the two groups were all lower, there was no statistical significance（P〉0.05）. Conclusion Internal fixation on lumbar vertebra in the treatment of lumbar disc herniation combined with instable lumbar vertebral degeneration has ideal effect, high recovery rate, low failure rate, and high safety, and has positive clinical significance.