全椎板切除减压与保留椎板减压联合植骨融合内固定治疗腰椎间盘突出症的效果

Effect of total laminectomy decompression and laminectomy preserving decompression combined with bone graft fusion and internal fixation in the treatment of lumbar disc herniation

目的探讨全椎板切除减压与保留椎板减压分别联合植骨融合内固定治疗腰椎间盘突出症的效果。方法选取2017年1月至2021年9月南通瑞慈医院收治的160例腰椎间盘突出症患者,按照随机数字表法分为参考组及试验组,每组各80例。参考组采用全椎板切除减压配合植骨融合内固定手术治疗,试验组采用保留椎板减压联合植骨融合内固定术治疗。比较两组患者的疗效、疼痛评分和腰椎功能以及并发症总发生率。结果两组患者的治疗优良率比较,差异无统计学意义(P>0.05)。试验组的手术时间、住院时间均短于参考组,术中出血量少于参考组,差异有统计学意义(P<0.05)。两组患者治疗前的疼痛视觉模拟评分法(VAS)、腰椎功能障碍指数(ODI)比较,差异无统计学意义(P>0.05)。两组患者治疗后的VAS、ODI均低于本组治疗前,且试验组低于参考组,差异有统计学意义(P<0.05)。两组患者的并发症总发生率比较,差异无统计学意义(P>0.05)。结论全椎板切除减压配合植骨融合内固定与保留椎板减压联合植骨融合内固定术治疗腰椎间盘突出症的疗效相当,但保留椎板植骨融合治疗能够缓解患腰腿疼痛和促进组织功能恢复,减少手术出血量,缩短手术时间及住院时间,并发症发生率低,具有一定的临床应用价值。

Objective To investigate the effect of total laminectomy decompression and laminectomy preserving decompression combined with bone graft fusion and internal fixation in the treatment of lumbar disc herniation.Methods A total of 160 patients with lumbar disc herniation admitted to Nantong Rich Hospital from January 2017 to September 2021 were selected and divided into the reference group and the experimental group according to the random number table method,with 80 cases in each group.The reference group was treated with total laminectomy decompression combined with bone graft fusion and internal fixation,and the experimental group was treated with laminectomy preserving decompression combined with bone graft fusion and internal fixation.The efficacy,pain score,lumbar function and the total incidence of complications were compared between the two groups.Results There was no significant difference in the excellent and good rate of treatment between the two groups(P>0.05).The operation time and hospitalization time of the experimental group were shorter than those of the reference group,and the intraoperative blood loss was less than that of the reference group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in visual analogue scale(VAS)and oswestry disability index(ODI)between the two groups before treatment(P>0.05).The VAS and ODI of the two groups after treatment were lower than those before treatment,and those of the experimental group were lower than those of the reference group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion The efficacy of total laminectomy decompression combined with bone graft fusion and internal fixation in the treatment of lumbar disc herniation is similar to that of laminectomy decompression combined with bone graft fusion and internal fixation,but the treatment of laminectomy and bone graft fusion can relieve the pain of lumbar and leg,promote the recovery of tissue function,reduce the amount of bleeding,shorten the operation time and hospitalization time,and reduce the occurrence of complications,which has certain clinical application value.