腰椎椎弓根螺钉加弹性棒内固定术治疗腰椎间盘突出症的效果观察

Observation on the Effect of Lumbar Pedicle Screw Plus Elastic Rod Internal Fixation in Treatment of Lumbar Disc Herniation

目的:分析腰椎椎弓根螺钉加弹性棒内固定术治疗腰椎间盘突出症(LDH)的效果。方法:选取2015年2月-2017年8月本院收治的LDH患者68例。按照手术方式不同将其分为观察组38例和对照组30例。观察组进行腰椎椎弓根螺钉加弹性棒内固定术治疗,对照组进行单纯椎间盘髓核摘除术治疗。比较两组手术前后的日本骨科协会评估治疗(JOA)评分、Oswestry功能障碍指数(ODI)评分、影像学检查结果(HD、HV、HI、DA以及手术节段椎管面积),以及治疗效果。结果:术前及术后1、6个月,两组JOA评分以及ODI指数比较,差异均无统计学意义(P>0.05);术后12个月,观察组JOA评分高于对照组,ODI指数低于对照组,比较差异均有统计学意义(P<0.05);两组显效率、有效率比较差异无统计学意义(P>0.05);术后12个月,观察组HD、HV、HI、DA以及手术节段椎管面积均优于对照组,比较差异均有统计学意义(P<0.05)。结论:腰椎椎弓根螺钉加弹性棒内固定术治疗LDH具有乐观的疗效且随着时间的延长,其可以有效地保持一定腰椎活动度,值得临床应用。

Objective:To analyze the effect of lumbar pedicle screw plus elastic rod internal fixation in treatment of lumbar disc herniation(LDH).Method:A total of 68 patients with LDH in our hospital from February 2015 to August 2017 were selected.According to the different surgical methods,they were divided into 38 cases of observation group and 30 cases of control group.The observation group was treated with lumbar pedicle screw plus elastic rod internal fixation,whilecontrol group was treated with simple discectomy.The JOA score,Oswestry dysfunction index(ODI)score,imaging findings(HD,HV,HI,DA and the area of the spinal canal at the operative level)before and after surgery and the therapeutic effect between two groups were compared.Result:Before and 1,6 months after operation,the JOA score and ODI index of two groups were compared,the differences were not statistically significant(P>0.05).At 12 months after operation,the JOA score of observation group was higher than that of control group,ODI index was lower than that of control group,the differences were statistically significant(P<0.05).The marked efficiency and efficiency between two groups were compared,the differences were not statistically significant(P>0.05).At 12 months after operation,the HD,HV,HI,DA and surgical segmental spinal canal area in observation group were better than those of control group,the differences were statistically significant(P<0.05).Conclusion:Lumbar pedicle screw plus elastic rod internal fixation for LDH has an optimistic effect and can effectively maintain a certain degree of lumbar motion over time,which is worthy of clinical application.