系统内固定加椎体间植骨术对腰椎失稳症合并腰椎管狭窄症的疗效

Efficacy of System Internal Fixation and Bone Graft on Lumbar Spinal Instability Combined with Lumbar Spinal Stenosis

目的:观察系统内固定加椎体间植骨术对腰椎失稳症合并腰椎管狭窄症患者的疗效。方法:确诊腰椎失稳症合并腰椎管狭窄症的中老年患者50例,采用半椎板和侧隐窝神经根管减压的方法,用椎弓根螺钉系统内固定加椎体间植骨手术治疗,术后2月、6月及1年随访,观察治疗效果,术前、术后2月、6月及1年视觉模拟(VAS)评分、腰痛、下肢痛、Oswestry功能障碍(ODI)指数、跛行距离及X线片测量结果。结果:与手术前比较,术后2月、6月及1年随访发现,随着随访时间的延长,治疗的有效率和治愈率逐渐增加,整体治疗效果明显高于手术前,随时间的延长,患者恢复越好;术后2月、6月及1年随访还发现,与术前比较,治疗后VAS与ODI评分均有降低,腰痛、下肢痛评分随着术后恢复时间延长评分逐渐下降,跛行距离增加,患者的腰椎前凸角、椎间隙高度增加,差异有统计学意义(P<0.05)。结论:系统内固定加椎体间植骨术治疗腰椎失稳症合并腰椎管狭窄症的效果良好。

Objective： To investigate the efficacy of system internal fixation and bone graft on patients with lumbar spinal instability combined with lumbar spinal stenosis. Methods： Fifty patients with lumbar spinal instability combined with lumbar spinal stenosis,adopting method of nerve root canal decompression of semi lamine and lateral reless. Treating with system internal fixation and bone graft,followup visit after two months,six months and one year of surgery to observe efficacy; before surgery,two months,six months and one year after surgery evaluating VAS score,low back pain,inferior limb pain,ODI index and X-ray result. Results： Comparing with pre-operative results,two months,six months and one year after surgery follow-up visit found that the treatment effective rate and recovery rate improved; overall treatment effective rate was higher than pre-operative test result. Furthermore,VAS score and ODI index decreased,scores of low back pain and inferior limb pain reduced as patients recover from surgery. Lumbar lordosis and intervetebral space height increased,comparing with preoperative results,differences were statistical significant（ P〈0. 05）. Conclusion： System internal fixation and bone graft on patients with lumbar spinal instability combined with lumbar spinal stenosis shows positive treatment efficacy.