可扩张通道单侧椎弓根内固定在腰椎融合术中的临床应用

Clinical Application of Single-side Pedicle Screw Fixation for Lumbar Posterior Fusion under Quadrant System

目的探讨经肌间隙可扩张通道单侧椎弓根内固定在单节段腰椎融合术中的临床应用价值。方法 2012年8月至2014年6月,随机选取我院具有完整临床资料和随访信息的经肌间隙可扩张通道单侧椎弓根螺钉固定的患者45例。观察末次随访Oswestry功能障碍指数评分(oswestry disability index,ODI)和腰腿痛视觉模拟评分(visual analogue scale,VAS),术后1年X线片/CT观察测量椎间隙高度及观察椎间融合情况。结果术后末次随访ODI、VAS评分及椎间隙高度较术前差异均有统计学意义(P<0.05),末次随访植骨融合率为100%。结论可扩张通道单侧椎弓根内固定在腰椎融合术中具有创伤小的优点,且疗效肯定,为腰椎退行性疾病的患者提供了一种简单、有效的治疗方法。

Objective To assess the clinical value of minimally invasive single-side pedicle screw fixation for lumbar posterior fusion. Methods A consecutive series of 45 patients who had undergone lumbar spinal fusion of 1 segment to treat degenerative lumbar disease was analyzed,which underwent TLIF with unilateral pedicle screw fixation under Quadrant system.More than 1 year all the patients were followed up with VAS scores and Oswestry disability questionnaire. All the patients accepted X-line/CT evaluation to compare the intervertebral height/fusion rates at the operative level pre-operation with post-operation. Results The ODI score,VAS score and intervertebral height were significantly improved when compared with preoperative one. The fusion rate were 100%. Conclusion Single-side pedicle screw fixation assisted by under Quadrant system caused less iatrogenic injury and had positive efforts post-operation. It can provide a simple and reliable choice in degenerative lumbar disease.