单侧减压融合联合对侧肌间隙入路内固定治疗腰椎间盘突出合并椎管狭窄患者的短期临床研究

Short-term Clinical Study of Unilateral Decompression and Fusion Combined with Internal Fixation through Contralateral Intermuscular Space Approach in the Treatment of Patients with Lumbar disc Herniation Combined with Lumbar Spinal Stenosis

目的探究单侧减压融合、对侧肌间隙入路内固定联合应用在腰椎间盘突出(lambar disc herniation,LDH)合并椎管狭窄(lumbar spinal stenosis,LSS)患者中的效果。方法选取2016年7月-2018年5月河南省洛阳正骨医院LDH合并LSS患者84例,依据随机数表法分组,各42例。对照组行后路椎体间融合术(posterior lumbar interbody fusion,PLIF),实验组行单侧减压融合、对侧肌间隙入路内固定联合治疗。统计对比两组手术指标、术前及术后3个月疼痛程度(VAS)、腰椎功能(JOA)评分。结果实验组手术及住院时间、术中出血量均少于对照组(P<0.05);实验组术后3个月VAS评分较对照组低,JOA评分较对照组高(P<0.05)。结论对侧肌间隙入路内固定、单侧减压融合联合治疗LDH合并LSS患者有助于改善手术情况,缓解患者疼痛,恢复腰椎功能,促进患者早期康复。

Objective To explore the effect of unilateral decompression and fusion combined with internal fixation through contralateral intermuscular space approach in patients with lambar disc herniation( LDH) combined with lumbar spinal stenosis (LSS).Methods 84 patients with LDH combined with LSS from July 2016 to May 2018 in Luoyang Orthopedic Hospital of Henan Province were selected and divided into 42 cases each according to random number table method.The control group received posterior lumbar interbody fusion (PLIF),while the experimental group received unilateral decompression fusion and internal fixation through contralateral intermuscular space approach.Statistically compared of two groups of surgical indicators,preoperative and postoperative 3 months pain degree (VAS),lumbar spine function (JOA) score.Results The duration of surgery,hospitalization and intraoperative blood loss in the experimental group were less than those in the control group (P < 0.05).The VAS score of the experimental group was lower than that of the control group 3 months after operation,and the JOA score was higher than that of the control group (P < 0.05).Conclusion Internal fixation through contralateral intermuscular space approach and unilateral decompression and fusion combined treatment for LDH patients with LSS is helpful to improve the operation condition,relieve the pain of patients,restore lumbar function and promote the early recovery of patients.