椎间盘镜下建立椎弓根钉通道行后路腰椎椎体间融合术临床研究

Clinical study of posterior lumbar interbody fusion using pedicle screw system under intervertebral disc

目的探究椎间盘镜下建立椎弓根钉通道行后路腰椎椎体间融合术的临床效果。方法回顾性分析2010年2月~2012年3月玉林市红十字会医院92例腰椎间盘突出症患者的临床资料,其中46例患者选择椎间盘镜下建立椎弓根钉通道行后路腰椎椎体间融合术进行治疗(观察组),46例患者选择传统开放式后路椎间盘摘除椎弓根钉内固定术进行治疗(对照组)。比较两组手术患者的术中出血量、手术时间、住院时间,疼痛评分、椎间隙高度、临床好转率及满意度等临床治疗效果。结果观察组患者的术中出血量、手术时间、住院时间等均要明显少于对照组,差异有统计学意义(P<0.05);观察组治疗后的疼痛评分、椎间隙高度小于对照组,差异有统计学意义(P<0.05);观察组患者治疗后的临床好转率高于对照组,差异有统计学意义(P<0.05)。观察组总满意率高于对照组,差异有统计学意义(P<0.05)。结论椎间盘镜下建立椎弓根钉通道行后路腰椎椎体间融合术的临床效果显著,疗效确切,且术中出血量少、切口小、术后恢复也快,值得研究推广。

Objective To explore the clinical effect of intervertebral fusion after lumbar intervertebral disc fusion under the intervertebral disc. Methods From February 2010 to March 2012, in Yulin Red Cross Hospital, the clinical data of92 patients with lumbar disc herniation were retrospectively analyzed. 46 patients treated with pedicle screw channel posterior lumbar interbody fusion by intervertebral disc were as observation group, 46 patients treated with traditional open posterior intervertebral disc extraction and pedicle screw fixation were as control group. The intraoperative blood loss, operation time, hospitalization time, pain score, intervertebral height, clinical improvement rate and satisfaction rate of the two groups were compared. Results The intraoperative blood loss, operation time and length of hospitalization in the observation group were significantly lower than those in the control group, the differences were statistically significant（P〈0.05）. After the treatment, the pain score, vertebral space of the observation group were less than those of the control group, the differences were statistically significant（P〈0.05）. The clinical improvement rate in the observation group was higher than that in the control group, the differences were statistically significant（P〈0.05）. The total satisfaction rate in the observation group was higher than that in the control group, the differences were statistically significant（P〈0.05）. Conclusion The establishment of posterior lumbar intervertebral fusion with intervertebral disc through intervertebral disc is effective and effective, and it has less hemorrhage, less incision and quick recovery after operation. It is worthy of study and popularization.