经椎弓根动态固定术与髓核摘除术对腰椎间盘突出症患者预后腰椎功能恢复的影响分析

Analysis of the effect of transpedicular dynamic stabilization and nucleus pulposus removal on the prognosis of lumbar functional recovery in patients with lumbar disc herniation

目的探讨经椎弓根动态固定术与髓核摘除术对腰椎间盘突出症患者预后腰椎功能恢复的影响。方法102例腰椎间盘突出症患者,随机分为观察组(52例)与对照组(50例)。对照组给予髓核摘除术治疗,观察组在对照组基础上联合经椎弓根动态固定术治疗。比较两组手术前后(术前及术后3、6个月)腿、腰视觉模拟评分法(VAS)评分及改良日本骨科协会腰痛评分表(JOA)评分。结果术后3、6个月,两组患者腿、腰VAS评分均低于术前,JOA评分均高于术前,且观察组患者术后3个月腿VAS评分(2.8±1.0)分、腰VAS评分(2.5±1.1)分以及术后6个月腿VAS评分(1.1±0.1)分、腰VAS评分(1.2±0.3)分均低于对照组的(3.4±1.2)、(3.4±1.5)及(2.0±0.2)、(1.8±0.6)分,术后3个月JOA评分(23.4±3.6)分、术后6个月JOA评分(24.7±3.4)分均高于对照组的(20.4±3.1)、(22.1±3.3)分,差异具有统计学意义(P<0.05)。结论经椎弓根动态固定术与髓核摘除术联合治疗腰椎间盘突出症均可获得良好的疗效,患者对于术后腰椎功能恢复更为满意,对维持腰椎稳定性起积极作用。

Objective To discuss the effect of transpedicular dynamic stabilization and nucleus pulposus removal on the prognosis of lumbar functional recovery in patients with lumbar disc herniation.Methods A total of 102 patients with lumbar disc herniation were randomly divided into observation group(52 cases)and control group(50 cases).The control group was treated with nucleus pulposus removal,and the observation group was treated with transpedicular dynamic stabilization on the basis of the control group.The leg and waist visual analogue scale(VAS)scores and Japanese Orthopaedic Association(JOA)score before and after surgery(before surgery,3 months after surgery and 6 months after surgery)of the two groups were compared.Results At 3 and 6 months after surgery,the leg and waist VAS scores in both groups were lower than those before surgery in this group,and JOA score was higher than that before surgery in this group;the observation group had leg VAS score of(2.8±1.0)points and lumbar VAS score of(2.5±1.1)points at 3 months after surgery,and leg VAS score of(1.1±0.1)points and lumbar VAS score of(1.2±0.3)points at 6 months after surgery,which were lower than those of(3.4±1.2),(3.4±1.5)points and(2.0±0.2),(1.8±0.6)points in the control group;the observation group had JOA scores of(23.4±3.6)points at 3 months after surgery and(24.7±3.4)points at 6 months after surgery,both of which were higher than those of(20.4±3.1)and(22.1±3.3)points in the control group;the differences were statistically significant(P<0.05).Conclusion Both transpedicular dynamic stabilization and nucleus pulposus removal can obtain good curative effects in the treatment of lumbar disc herniation,and the patients are more satisfied with the postoperative lumbar function recovery,which plays a positive role in maintaining the stability of lumbar vertebra.