不同侧椎弓根钉内固定联合椎间融合术对腰椎退行性疾病患者的临床疗效

Clinical effect of pedicle screw fixation combined with interbody fusion in the treatment of lumbar degenerative disease

目的观察不同侧椎弓根钉内固定联合椎间融合术对腰椎退行性疾病患者的临床疗效。方法选取我院2013年5月—2015年7月行内固定联合椎间融合术治疗腰椎退行性疾病的患者39例,按照随机奇偶法分为观察组(15例)和对照组(14例)。所有患者均行椎间融合术治疗,观察组行双侧椎弓根钉内固定,对照组行单侧椎弓根钉内固定。记录2组患者手术时间、术中出血量、并发症情况、腰腿痛视觉模拟评分以及腰椎JOA评分结果。结果 2组患者并发症比较,无明显差异(P<0.05);观察组手术时间、术中出血量分别为(2.6±0.2)h、(278.5±20.7)ml,对照组为(3.8±0.7)h、(321.8±17.9)ml,观察组优于对照组,差异有统计学意义(P<0.05)。1年后随访,2组患者腰痛、腿痛视觉模拟评分以及腰椎JOA评分较术前比较,均有好转;随访后观察组与对照组各项评分相比,无明显差异(P>0.05)。结论单、双侧椎弓根钉内固定联合椎间融合术治疗腰椎退行性疾病中,疗效相近,都具有出血量少、手术时间短的特点。

Objective ： To observe the clinical effect of different lateral pedicle screw fixation combined with interbody fusion for lumbar degenerative diseases. Methods： A total of 39 patients in our hospital during May 2013--July 2015 for internal fixation and interbody fusion in treatment of lumbar degenerative disease patients, were divided into observation group （ 15 cases） and control group （14 cases） according to random parity, all patients underwent lumbar interbody fusion in the treatment. The observation group underwent bilateral pedicle screw fixation, the control group underwent unilateral pedicle screw fixation. The records were done of the operation time, bleeding volume during operation, complications, pain visual analogue score and lumbar JOA （Japanese Orthopaedic Association Scores） score results. Results ： In the two groups of patients complications had no obvious difference （P 〈 0.05） ; The operation time, and volume of blood loss were （2.6 ± 0.2）h, （278.5 ± 0.7） ml respectively in the observation group , while in the control group they were （3.8 ± 0.7） h, （321.8 ± 17.9） ml, and there was statistically significant difference （P 〈 0.05）. After 1 years of follow-up, 2 patients had low back pain, and leg pain visual analogue score and lumbar JOA score comparison were improved ; The follow-up group and control group were compared, there was no significant difference （P 〉 0.05 ）. Conclusion： Single and bilateral pedicle screw fixation combined with interbody fusion in the treatment of lumbar degenerative disease has similar curative effect, with less bleeding and shorter operation time.