单边椎弓根钉棒内固定联合椎间融合术治疗腰椎间盘突出症的效果及对脊柱稳定性、MRI影像特征的影响

Effect of unilateral pedicle screw rod internal fixation combined with interbody fusion on lumbar disc herniation and its influence on spinal stability and MRI image characteristics

目的 探讨单边椎弓根钉棒内固定联合椎间融合术治疗腰椎间盘突出症(LDH)的效果及对脊柱稳定性、磁共振成像(MRI)影像特征的影响。方法 选取我院收治的98例LDH患者为研究对象,将其随机分为对照组(49例,双边椎弓根钉棒内固定联合椎间融合术)和研究组(49例,单边椎弓根钉棒内固定联合椎间融合术)。比较两组的治疗效果。结果 研究组的治疗优良率高于对照组(P<0.05)。研究组的手术时间短于对照组,术中出血量少于对照组,术后3个月Oswestry功能障碍指数(ODI)评分及术后1年邻近节段椎体退变率低于对照组(P<0.05)。术后1年,研究组的腰椎后凸角大于对照组,矢状面平衡、颌眉角小于对照组(P<0.05)。术后1周,研究组病变部位椎体膨出程度、椎间隙高度、硬膜外压痕纵轴及矢径均小于对照组(P<0.05)。结论 单边椎弓根钉棒内固定联合椎间融合术治疗LDH的效果显著,较双边固定的创伤小,更有利于恢复脊柱稳定性及腰椎功能,降低邻近节段的退变风险。

Objective To investigate the effect of unilateral pedicle screw rod internal fixation combined with interbody fusion on lumbar disc herniation(LDH) and its influences on spinal stability and magnetic resonance imaging(MRI) image characteristics.Methods A total of 98 LDH patients admitted in our hospital were selected as the research objects and randomly divided into control group(49 cases,bilateral pedicle screw rod internal fixation combined with interbody fusion)and research group(49 cases,unilateral pedicle screw rod internal fixation combined with interbody fusion).The therapeutic effects of the two groups were compared.Results The excellent and good rate in the research group was higher than that in the control group(P<0.05).The operation time in the research group was shorter than that in the control group,the intraoperative bleeding volume was less than that in the control group,and the Oswestry Disability Index(ODI) score at3 months after operation and the degeneration rate of adjacent vertebral body at 1 year after operation were lower than those in the control group(P<0.05).One year after operation,the lumbar kyphosis angle in the research group was larger than those in the control group,and the sagittal plane balance and the maxillary eyebrow angle in the research group were smaller than those in the control group(P<0.05).One week after operation,the degree of vertebral bulging at the lesion site,the height of intervertebral space,the longitudinal axis and vector diameter of epidural indentation in the research group were less than those in the control group(P <0.05).Conclusion Unilateral pedicle screw rod internal fixation combined with interbody fusion on LDH has a significant effect,with less traumatic than bilateral fixation,which is more conducive to restoring spinal stability and lumbar function,and reducing the risk of degeneration of adjacent segments.