CAJ | 학술논문

目的探讨改良经椎间孔椎体间融合术治疗腰椎退变性疾病的临床疗效.方法 2007年6月至2009年5月对62例腰椎退变性疾病患者行改良经单侧椎间孔椎体间植骨融合,相应节段椎弓根钉内固定术.其中腰椎间盘突出合并腰椎不稳28例,腰椎间盘突出合并椎管狭窄27例,退变性滑脱7例.累及单节段48例,累及双节段14例.通过观察融合情况,记录术前、术后3个月和末次随访时的视觉模拟评分(VAS)和日本矫形外科学会(JOA)评分判定治疗效果.结果 62例患者均获得随访,随访时间15～30(22.77±3.82)个月.无神经损伤、脑脊液漏、感染及椎弓根钉断裂等并发症.术后1年椎体间融合率为96.8%.依据JOA评分,优34例,良24例,可4例,差0例,优良率为93.5%(58/62).术后VAS和JOA评分与术前比较差异有统计学意义(P＜0.05),术后3个月VAS和JOA评分与末次随访时比较差异无统计学意义(P＞0.05).结论改良经椎间孔椎体间融合术在充分减压同时能减少进入椎管带来的并发症,临床疗效好,是治疗腰椎退变性疾病的有效术式.
목적 탐토개량경추간공추체간융합술치료요추퇴변성질병적림상료효.방법 2007년6월지2009년5월대62례요추퇴변성질병환자행개량경단측추간공추체간식골융합,상응절단추궁근정내고정술.기중요추간반돌출합병요추불은28례,요추간반돌출합병추관협착27례,퇴변성활탈7례.루급단절단48례,루급쌍절단14례.통과관찰융합정황,기록술전、술후3개월화말차수방시적시각모의평분(VAS)화일본교형외과학회(JOA)평분판정치료효과.결과 62례환자균획득수방,수방시간15～30(22.77±3.82)개월.무신경손상、뇌척액루、감염급추궁근정단렬등병발증.술후1년추체간융합솔위96.8%.의거JOA평분,우34례,량24례,가4례,차0례,우량솔위93.5%(58/62).술후VAS화JOA평분여술전비교차이유통계학의의(P＜0.05),술후3개월VAS화JOA평분여말차수방시비교차이무통계학의의(P＞0.05).결론 개량경추간공추체간융합술재충분감압동시능감소진입추관대래적병발증,림상료효호,시치료요추퇴변성질병적유효술식.
Objective To investigate the chnical effect of modified transforaminal lumbar interbody fusion (TLIF) on the treatment of lumbar degenerative disease. Methods Sixty-two patients with lumbar degenerative disease were treated by the modified TLIF from June 2007 to May 2009. The preoperative diagnosis was lumbar intervertebral disc herniation with spinal instability (28 cases), lumbar intervertebral disc herniation with lumbar stenosis (27 cases ), degenerative spondylohsthesis (7 cases ). Forty-eight cases were single-level and 14 cases were two-level. The patients were evaluated by observing the fusion rate and comparing the visual analog score( VAS ) and Japanese orthopaedics association (JOA) score of preoperation with those of postoperation. Results All the patients were followed up from 15 to 30 (22.77 ± 3.82)months,no nerve injury,leakage of cerebralspinal,infection,the broken of pedical screws and other complications. The fusion rate of segment was 96.8% at the follow-up after 1 year postoperatively. Judgement by JOA score,the rate of improvement was 93.5%(58/62),excellent in 34 cases,good in 24 cases,fair in 4 cases. The postoperative value of V AS and JOA score were higher than those of preoperation (P ＜ 0.05 ), the values when follow-up of 3 months was performed had no statistic al difference with those of final follow-up (P＞0.05). Conclusion The modified TLIF with fully decompression while reducing the accessing spinal canal complications have good clinical efficacy in treating lumbar degenerative disease.