中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
5期
4-6
,共3页
椎间盘%腰痛%脊柱融合术%治疗结果
椎間盤%腰痛%脊柱融閤術%治療結果
추간반%요통%척주융합술%치료결과
Intervertebral disc%Low back pain%Spinal fusion%Treatment outcome
目的 探讨椎间盘源性腰痛的诊断方法及最佳的治疗方案.方法 回顾性分析132例经椎间盘造影检查诊断为椎间盘源性腰痛患者的临床资料.按随机数字表法随机分为三组:A组行经皮激光椎间盘气化减压术63例;B组行前路腹膜外椎间盘切除结合Cage植骨融合术21例;C组行后路椎间盘切除结合后外侧融合椎弓根螺钉固定术48例.术后观察各组患者视觉模拟法(VAS)评分及Oswestry功能障碍指数(ODI)评分的改善程度.结果 腰椎MRI上病变椎间盘T_2加权像低信号有重要意义.三组术后VAS评分降低值依次降低,A组(9.7±0.9)分,B组(7.4±1.2)分,C组(6.9±1.4)分,A组与B、C组比较差异有统计学意义(P<0.05).三组术后ODI评分降低值也依次降低,A组(19.4±1.4)分,B组(18.8±2.9)分,C组(16.5±2.1)分.A组与B、C组比较差异有统计学意义(P<0.05).结论 椎间盘造影是目前诊断椎间盘源性腰痛的可靠方法;经皮激光椎间盘气化减压术与前路或后路椎间盘切除结合内固定术及融合术比较在改善患者疼痛与功能方面均有良好效果.
目的 探討椎間盤源性腰痛的診斷方法及最佳的治療方案.方法 迴顧性分析132例經椎間盤造影檢查診斷為椎間盤源性腰痛患者的臨床資料.按隨機數字錶法隨機分為三組:A組行經皮激光椎間盤氣化減壓術63例;B組行前路腹膜外椎間盤切除結閤Cage植骨融閤術21例;C組行後路椎間盤切除結閤後外側融閤椎弓根螺釘固定術48例.術後觀察各組患者視覺模擬法(VAS)評分及Oswestry功能障礙指數(ODI)評分的改善程度.結果 腰椎MRI上病變椎間盤T_2加權像低信號有重要意義.三組術後VAS評分降低值依次降低,A組(9.7±0.9)分,B組(7.4±1.2)分,C組(6.9±1.4)分,A組與B、C組比較差異有統計學意義(P<0.05).三組術後ODI評分降低值也依次降低,A組(19.4±1.4)分,B組(18.8±2.9)分,C組(16.5±2.1)分.A組與B、C組比較差異有統計學意義(P<0.05).結論 椎間盤造影是目前診斷椎間盤源性腰痛的可靠方法;經皮激光椎間盤氣化減壓術與前路或後路椎間盤切除結閤內固定術及融閤術比較在改善患者疼痛與功能方麵均有良好效果.
목적 탐토추간반원성요통적진단방법급최가적치료방안.방법 회고성분석132례경추간반조영검사진단위추간반원성요통환자적림상자료.안수궤수자표법수궤분위삼조:A조행경피격광추간반기화감압술63례;B조행전로복막외추간반절제결합Cage식골융합술21례;C조행후로추간반절제결합후외측융합추궁근라정고정술48례.술후관찰각조환자시각모의법(VAS)평분급Oswestry공능장애지수(ODI)평분적개선정도.결과 요추MRI상병변추간반T_2가권상저신호유중요의의.삼조술후VAS평분강저치의차강저,A조(9.7±0.9)분,B조(7.4±1.2)분,C조(6.9±1.4)분,A조여B、C조비교차이유통계학의의(P<0.05).삼조술후ODI평분강저치야의차강저,A조(19.4±1.4)분,B조(18.8±2.9)분,C조(16.5±2.1)분.A조여B、C조비교차이유통계학의의(P<0.05).결론 추간반조영시목전진단추간반원성요통적가고방법;경피격광추간반기화감압술여전로혹후로추간반절제결합내고정술급융합술비교재개선환자동통여공능방면균유량호효과.
Objective To investigate the diagnosis method of intervertebral disc low back pain and the best treatment clinical efficacy. Methods The imaging data of 132 cases with intervertebral disc low back pain diagnosed by discography for disc imaging was retrospectively analyzed from October 2001 to October 2008. Randomly divided into three groups: group A of pereutaneous laser disc decompression in 63 cases of gasification, group B extraperitoneal anterior disectomy, Cage fusion 21 cases, group C posterior fusion after disectomy arch root 48 cases of screw fixation. Observed in patients with postoperative visual analogue scale (VAS) and Oswestry disability index (ODI) score improvement. Results MRI of lumbar intervertebral disc on T_2-weightod lesions as low signal was important. VAS after treatment in three groups followed by lower values to reduce, group A was (9.7 ± 0.9) points, group B was (7.4 ± 1.2) points, group C was (6.9 ± 1.4) points. There were statistically significance between group A and group B, C (P< 0.05). ODI in order to reduce the value of reducing, group A was (19.4 ± 1.4) points, group B was (18.8 ± 2.9) points, group C was (16.5 ± 2.1) points. There were statistically significance between group A and group B, C (P< 0.05). Conclusions Discography is a reliable method to diagnose intervertebral disc low back pain. Percutaneens laser disc decompression compared with posterior or anterior disectomy and fusion combined with internal fixation has good results in improving pain and function of patients.
