后路小开窗髓核摘除结合弹性棒内固定治疗腰椎间盘突出症的随机对照研究
|
摘要
目的:探讨后路小开窗髓核摘除结合弹性棒内固定治疗腰椎间盘突出症的临床效果。方法:选择2015年1月～2016年9月在本院就诊的腰椎间盘突出症患者94例,采用随机数字表法将患者分为A组和B组,各47例。A组给予后路椎板开窗髓核摘除联合椎间融合治疗,B组给予后路小开窗髓核摘除结合弹性棒内固定治疗。观察2组术前、术后1月、6月、12月腰腿痛视觉模拟评分(VAS)、术前、术后1年手术节段活动度和上位节段活动度。结果:2组术后1月、术后6月、术后1年腰痛和腿痛VAS与术前相比较均显著降低(P<0.05);且B组术后6月、术后1年腰痛和腿痛VAS与A组相比较均显著降低(P<0.05)。结论:后路小开窗髓核摘除结合弹性棒内固定治疗腰椎间盘突出症有利于改善患者临床症状,保留患者手术节段活动度,具有良好的近期疗效。
Objective: To explore the clinical effect of posterior fenestration combined with elastic bar fixation in the treatment of lumbar disc herniation. Methods:94 patients with lumbar disc herniation who visited our hospital from January 2015 to September 2016 were selected. Group A was treated with posterior fenestration combined with intervertebral fusion, while group B was treated with posterior fenestration combined with internal fixation with elastic bar. Visual analogue scale(VAS) for lumbar and leg pain in the two groups before and after surgery(I month, 6 months, and 12 months), operative segmental activity and upper segmental activity I year after surgery and 1 year after surgery were observed. Results: VAS of 1 month after operation, 6 months after operation, 1 year after operation and I year after operation were significantly reduced compared with that before operation(P<0.05). In addition, VAS of lumbago and leg pain were significantly decreased 6 months after surgery and I year after surgery in group B compared with group A(P<0.05). Conclusion: The posterior approach of small fenestration combined with internal fixation of elastic bar can improve the clinical symptoms of lumbar intervertebral disc herniation, maintain the activity of surgical segment, and have a good short-term effect.
Objective: To explore the clinical effect of posterior fenestration combined with elastic bar fixation in the treatment of lumbar disc herniation. Methods:94 patients with lumbar disc herniation who visited our hospital from January 2015 to September 2016 were selected. Group A was treated with posterior fenestration combined with intervertebral fusion, while group B was treated with posterior fenestration combined with internal fixation with elastic bar. Visual analogue scale(VAS) for lumbar and leg pain in the two groups before and after surgery(I month, 6 months, and 12 months), operative segmental activity and upper segmental activity I year after surgery and 1 year after surgery were observed. Results: VAS of 1 month after operation, 6 months after operation, 1 year after operation and I year after operation were significantly reduced compared with that before operation(P<0.05). In addition, VAS of lumbago and leg pain were significantly decreased 6 months after surgery and I year after surgery in group B compared with group A(P<0.05). Conclusion: The posterior approach of small fenestration combined with internal fixation of elastic bar can improve the clinical symptoms of lumbar intervertebral disc herniation, maintain the activity of surgical segment, and have a good short-term effect.
引文
[1]刘凤松,王凯,景成伟.等.后路钉棒内固定椎间融合治疗复发性腰椎间盘突出症:椎体稳定性评价[J].中国组织工程研究,2014,18(4):553-558.
[2]曹正霖,周守国,黄耀渠,等.弹性棒动态内固定治疗退行性疾病的初期效果[J].广东医学,2014,35(1):82-84.
[3]过锡敏.微创与开放后路腰椎间融合修复单节段腰椎退变性疾病:椎间融合率比较[J].中国组织工程研究,2015,19(39):6321-6326.
[4]赵建辉.后路开窗减压髓核摘除结合Wallis系统固定治疗腰推间盘突出[J].西南国防医药,2015,25(3):249-252.
[5]邸宁,王浩明,李瀚卿,等.K-Rod动态固定治疗腰椎间盘突出症39例报告[J].中国骨与关节杂志,2013,2(6):322-327.
[2]曹正霖,周守国,黄耀渠,等.弹性棒动态内固定治疗退行性疾病的初期效果[J].广东医学,2014,35(1):82-84.
[3]过锡敏.微创与开放后路腰椎间融合修复单节段腰椎退变性疾病:椎间融合率比较[J].中国组织工程研究,2015,19(39):6321-6326.
[4]赵建辉.后路开窗减压髓核摘除结合Wallis系统固定治疗腰推间盘突出[J].西南国防医药,2015,25(3):249-252.
[5]邸宁,王浩明,李瀚卿,等.K-Rod动态固定治疗腰椎间盘突出症39例报告[J].中国骨与关节杂志,2013,2(6):322-327.