不同椎间融合方式结合单侧椎弓根钉固定治疗腰椎间盘突出症的疗效比较

Comparison of different Methods of interbody fusion combined with unilateral pedicle screw fixation in the treatment of lumbar disc herniation

目的探讨椎间单纯打压植骨与Cage植骨结合单侧椎弓根钉内固定治疗腰椎间盘突出症的临床效果。方法回顾性分析2015年1月-2018年1月于本院采用不同椎间融合方式结合单侧椎弓根钉固定治疗的52例腰椎间盘突出症。其中,单侧椎弓根钉内固定+Cage植骨30例(Cage组),单侧椎弓根钉内固定+局部植骨22例(非Cage组)。对两组手术情况和相关疗效指标进行比较。结果Cage组与非Cage组在手术时间、出血量、术后VAS评分、术后椎间隙高度、随访VAS评分、随访ODI指数以及终末随访椎间隙高度之间差异无统计学意义(P>0.05),两组融合率以及并发症发生率的差异也无统计学意义(P>0.05)。结论使用与不使用Cage联合单侧椎弓根螺钉内固定治疗腰椎间盘突出症均可获得满意的疗效,且非Cage组具有费用较低的优势,单侧椎弓根钉内固定+局部植骨是一种安全可行的手术方法。

Objective To compare the clinical effects of posterior unilateral pedicle screw fixation with and without cage bone grafting in the treatment of lumbar disc herniation.Methods A total of 52 patients who underwent posterior lumbar interbody fusion(PLIF)in our institution were evaluated from January 2015 to January 2018.Thirty patients who received PLIF with local bone graft combined with using one cage were selected as cage group,and 22 patients who received PLIF with local bone graft without using cage were selected as non-cage group.The operation conditions and related therapeutic indicators were compared between the two groups.Results There were no significant differences in operation time,blood loss,postoperative VAS score,postoperative intervertebral space height,follow-up VAS score,follow-up ODI index,and final follow-up intervertebral space height between the two groups(P>0.05).No significant differences were found in fusion rate and incidence rate of complications between the two groups(P>0.05).Conclusion Local bone graft has the same advantages as bone graft fusion cage in single PLIF.Comparing with local bone graft using a single cage,we believe that the purely local bone graft is a more ideal way in single PLIF,and also has the advantage of low operation cost.