通道减压单侧非融合固定治疗腰椎间盘突出症

Decompression and unilateral non-fusion pedicle screw fixation by the Quadrant channel for lumbar disc herniation

[目的]探讨通道减压单侧非融合固定治疗腰椎间盘突出症的近期疗效。[方法]2017年1月—2019年4月采用通道减压单侧非融合固定技术治疗腰椎间盘突出症及单侧侧隐窝狭窄患者50例,其中,单节段42例,双节段8例。分析围手术期及随访结果。[结果]所有患者均顺利完成手术,无严重并发症。单节段组手术时间、切口长度、术中透视次数、术后引流量显著少于双节段组(P<0.05)。两组术后下地时间和住院时间的差异均无统计学意义(P>0.05)。所有患者随访(21.83±6.87)个月,随时间推移,患者腰痛及腿痛VAS评分,以及ODI评分均显著降低(P<0.05),临床结果优41例,良6例,可3例,优良率达94.00%。[结论]通道减压单侧非融合固定技术治疗腰椎间盘突出及单侧侧隐窝狭窄,创伤小,近期效果良好,但远期的疗效还需进一步观察。

[Objective]To explore the short-term clinical outcomes of decompression and unilateral non-fusion pedicle screw fixation by the Quadrant channel for lumbar disc herniation.[Methods]From January 2017 to April 2019,a total of 50 patients underwent abovementioned surgical treatment for lumbar disc herniation complicated with or without unilateral lateral recess stenosis,including 42 cases with single level involved and 8 cases with double levels affected.The perioperative and follow-up results were analyzed.[Results]All patients were successfully operated on without serious complications.Although the single-segment group had significantly less operative time,incision length,intraoperative fluoroscopy times and postoperative drainage than the double-segment group(P<0.05),there were no significant differences in postoperative ambulation time and hospital stay between the two groups(P>0.05).As time went during the follow-up lasted for(21.83±6.87)months,the VAS scores for low back pain and leg pain,as well as the ODI score significantly decreased(P<0.05).The clinical results were graded as excellent in 41 cases,good in 6 cases and fair in 3 cases,with the excellent and good rate of 94.00%at the latest follow-up.[Conclusion]The decompression and unilateral non-fusion pedicle screw fixation by the Quadrant channel do achieve satisfactory short-term outcomes for lumbar disc herniation with or without unilateral recess stenosis with minimizing iatrogenic trauma,however the long-term consequence needs further observation.