后路椎弓根钉棒内固定融合术治疗椎间盘突出症伴椎管狭窄的效果

Effect of Posterior Pedicle Screw and Rod Internal Fixation and Fusion in Treatment of Intervertebral Disc Herniation With Spinal Stenosis

目的:探讨后路椎弓根钉棒内固定融合治疗椎间盘突出症伴椎管狭窄的效果。方法:选取2020年1月—2021年12月贵港市覃塘区人民医院收治的120例椎间盘突出症伴椎管狭窄患者中作为研究对象,根据术式选择分为观察组与对照组,各60例。对照组采取单纯椎板切除椎管减压及髓核摘除术治疗,观察组采取后路椎弓根钉棒内固定融合术,比较两组治疗效果、手术前后日本骨科协会评估治疗(JOA)评分、不良反应发生情况。结果:观察组治疗有效率高于对照组,差异有统计学意义(P<0.05)。术前,两组JOA评分比较,差异无统计学意义(P>0.05);术后3个月和末次随访,观察组JOA评分高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:关于椎管狭窄伴椎间盘突出症患者临床建议采取后路椎弓根钉棒内固定融合进行治疗,治疗效果显著,能有效提高患者治疗有效率,加快术后恢复进度,且不良反应少,安全性较高。

Objective:To explore the effect of posterior pedicle screw and rod internal fixation and fusion in the treatment of intervertebral disc herniation with spinal stenosis.Methods:From January 2020 to December 2021,a total of 120 patients with intervertebral disc herniation and spinal stenosis who were admitted to People's Hospital of Qintang District of Guigang City were selected as the study subjects.According to the selection of surgical approach,the patients were divided into observation group and control group,with 60 cases in each group.The control group was treated with simple laminectomy,spinal canal decompression and nucleus pulposus removal,and the observation group was treated with posterior pedicle screw and rod internal fixation and fusion.The treatment effect,Japanese Orthopaedic Association(JOA)score before and after surgery,and occurrence of adverse reactions in the two groups were compared.Results:The treatment response rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference in JOA scores between the two groups(P>0.05).At 3 months after surgery and at the last follow-up visit,the JOA score in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:For the patients with intervertebral disc herniation and spinal stenosis,it is clinically recommended to perform posterior pedicle screw and rod internal fixation and fusion.The treatment effect is significant,the treatment can effectively improve the treatment response rate of patients,accelerate the postoperative recovery progress,with few adverse reactions and high safety.