30例椎间盘源性腰痛手术治疗的疗效观察

Clinical observation of the surgical treatment for 30 patients with discogenic low back pain

目的总结30例椎间盘源性腰痛患者的手术治疗临床效果。方法 2010年4月—2014年2月对30例严格标准诊断的腰椎间盘源性腰痛患者(共计36个椎间盘),行后方入路腰椎间盘切除椎间植骨融合内固定术。术后随访1年,采用日本骨科协会(Japanese Orthopaedic Association,JOA)评估治疗评分对患者术前和术后的腰椎功能进行评估,采用视觉模拟评分法(Visual Analogue Scale,VAS)对患者术前和术后的腰部疼痛进行评估。结果 30例患者术后腰椎功能及下腰部疼痛均明显改善,JOA评分从术前(14.6±2.3)分提高至术后1年(27.1±0.9)分,差异有统计学意义(t=–26.936,P<0.001);VAS评分从术前(6.2±1.6)分降低至术后1年(1.4±0.9)分,差异有统计学意义(t=16.335,P<0.001)。结论对经过严格标准诊断,正规保守治疗无效的椎间盘源性腰痛患者,后路腰椎间盘切除椎间植骨融合内固定术是治疗椎间盘源性腰痛的有效方法。

Objective To evaluate the clinical effects of surgical treatment for 30 patients with discogenic low back pain. Methods A total of 30 patients with 36 intervertebral discs were treated with posterior approach lumbar discectomy and interbody fusion with internal fixation by strict criteria. All patients were followed up for one year. The low back pain before and one year after surgery was evaluated by Japanese Orthopaedic Association （JOA） score and Visual Analogue Scale （VAS） score. Results The patients＇ JOA score increased from 14.6±2.3 （before operation） to 27.1±0.9 （one year after operation） （t=-26.936, P〈0.001）, while the patients＇ VAS score decreased from 6.2±1.6 （before operation） to 1.4±0.9 （one year after operation） （t=16.335, P〈0.001）, and the differences were significant. Conclusion When the conservative treatment is invalid, the operation of posterior lumbar intervertebral fusion is an effective method for the patinets with discogenic low back pain.