中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
25期
6-8
,共3页
易军飞%黄卫国%白瑞飞%陈通%刘友军
易軍飛%黃衛國%白瑞飛%陳通%劉友軍
역군비%황위국%백서비%진통%류우군
退变性腰椎间盘突出症%椎弓根螺钉固定%椎间融合术%横突间融合术
退變性腰椎間盤突齣癥%椎弓根螺釘固定%椎間融閤術%橫突間融閤術
퇴변성요추간반돌출증%추궁근라정고정%추간융합술%횡돌간융합술
Degenerative lumbar disc herniation%Pedicle screw fixation%Intervertebral bone fusion%Intertransverse-bone fusion
目的：总结后路椎间盘摘除自体椎间植骨和横突间植骨融合椎弓根内固定两种手术方法治疗退变性椎间盘突出症的疗效。方法：对76例（122个腰椎节段）退变性椎间盘突出症患者行后路椎间盘摘除自体骨移植融合椎弓根内固定术，其中45例采用自体骨椎间植骨，31例采用自体骨横突间植骨，同时随访观察初期的临床疗效。结果：76例获随访，时间6~76个月，疗效评定应用Oswestry功能障碍指数（ODI）评定。椎间融合组优31例，良10例。优良率91.1%，横突间融合组优25例，良4例，优良率93.5%。骨融合率椎间融合组100%，横突间融合组96.8%。结论：后路椎间盘摘除自体椎间植骨和横突间植骨融合椎弓根内固定两种手术方法治疗退变性腰椎间盘突出症，临床疗效满意。在认真探讨和明确LDH腰腿痛的主导致病机制后，针对性采用不同融合方式。横突间融合组费用和并发症更少。
目的：總結後路椎間盤摘除自體椎間植骨和橫突間植骨融閤椎弓根內固定兩種手術方法治療退變性椎間盤突齣癥的療效。方法：對76例（122箇腰椎節段）退變性椎間盤突齣癥患者行後路椎間盤摘除自體骨移植融閤椎弓根內固定術，其中45例採用自體骨椎間植骨，31例採用自體骨橫突間植骨，同時隨訪觀察初期的臨床療效。結果：76例穫隨訪，時間6~76箇月，療效評定應用Oswestry功能障礙指數（ODI）評定。椎間融閤組優31例，良10例。優良率91.1%，橫突間融閤組優25例，良4例，優良率93.5%。骨融閤率椎間融閤組100%，橫突間融閤組96.8%。結論：後路椎間盤摘除自體椎間植骨和橫突間植骨融閤椎弓根內固定兩種手術方法治療退變性腰椎間盤突齣癥，臨床療效滿意。在認真探討和明確LDH腰腿痛的主導緻病機製後，針對性採用不同融閤方式。橫突間融閤組費用和併髮癥更少。
목적：총결후로추간반적제자체추간식골화횡돌간식골융합추궁근내고정량충수술방법치료퇴변성추간반돌출증적료효。방법：대76례（122개요추절단）퇴변성추간반돌출증환자행후로추간반적제자체골이식융합추궁근내고정술，기중45례채용자체골추간식골，31례채용자체골횡돌간식골，동시수방관찰초기적림상료효。결과：76례획수방，시간6~76개월，료효평정응용Oswestry공능장애지수（ODI）평정。추간융합조우31례，량10례。우량솔91.1%，횡돌간융합조우25례，량4례，우량솔93.5%。골융합솔추간융합조100%，횡돌간융합조96.8%。결론：후로추간반적제자체추간식골화횡돌간식골융합추궁근내고정량충수술방법치료퇴변성요추간반돌출증，림상료효만의。재인진탐토화명학LDH요퇴통적주도치병궤제후，침대성채용불동융합방식。횡돌간융합조비용화병발증경소。
Objective:To investigate effectiveness of two kinds of surgical treatments,posterior discectomy autologous intervertebral bone graft and intertransverse-bone graft on transpedicular internal fixation,on the degenerative disc herniation.Method:Among 76 patients(122 lumbar segment)with degenerative disc disease went through posterior discectomy under autogenous bone graft fusion pedicle screw fixation.Of which,45 patients were treated with autologous intervertebral bone graft and the rest were treated with autogenous intertransverse-bone graft.The initial clinical results were measured regularly.Result:The follow-up period was 6 to 76 months. Oswestry Disability Index(ODI)was applied to assess the treatment efficacy.In the intervertebral bone graft group,there were 31 excellent cases and 10 good cases,with good-excellent ratio at 91.1%. In the intertransverse-bone graft group,there were 25 excellent cases and 4 good cases,with good-excellent ratio at 93.5%.Bone fusion rate was 100%for the intervertebral bone graft group and 96.8%for intertransverse-bone graft group. Conclusion:The effectiveness of two kinds of surgical treatments,posterior discectomy autologous intervertebral bone graft and intertransverse-bone graft on transpedicular internal fixation,on the degenerative disc herniation is satisfactory. After carefully explored and clarified the dominant pathogenic mechanism of LDH low back pain,we selectively use different fusions.Intertransverse bone fusion has low operation costs and leads to fewer complications.
