CAJ | 학술논문

目的：探讨小切口椎板开窗微创术联合腰椎内固定植骨融合术治疗腰椎间盘突出合并腰椎不稳的临床应用价值。方法：本院2007年1月至2012年1月共80例腰椎间盘突出合并腰椎不稳的患者，均予椎板切除减压同时行腰椎内固定加椎间植骨融合术，按照手术方式不同进行分组，其中行小切口椎板开窗微创术联合腰椎内固定植骨融合术40例（ A组），全椎板切除术联合腰椎内固定植骨融合术40例（ B组）。回顾性分析两组临床资料及术后随访材料，比较其术中表现及术后疗效。结果：A组患者的切口长度、手术时间、术中出血量及卧床时间均显著小于B组患者，差异具有统计学意义（ P＜0．05）；经手术治疗后，A组患者治疗的有效率以及术后6个月ODI指数改善35分以上的人数显著高于B组，神经根损伤的发生率显著低于B组，差异具有统计学意义（ P＜0．05）。结论：小切口椎板开窗微创术联合腰椎内固定植骨融合术具有手术时间短、创伤轻、融合率高、恢复快等优点，值得在临床上推广应用。
목적：탐토소절구추판개창미창술연합요추내고정식골융합술치료요추간반돌출합병요추불은적림상응용개치。방법：본원2007년1월지2012년1월공80례요추간반돌출합병요추불은적환자，균여추판절제감압동시행요추내고정가추간식골융합술，안조수술방식불동진행분조，기중행소절구추판개창미창술연합요추내고정식골융합술40례（ A조），전추판절제술연합요추내고정식골융합술40례（ B조）。회고성분석량조림상자료급술후수방재료，비교기술중표현급술후료효。결과：A조환자적절구장도、수술시간、술중출혈량급와상시간균현저소우B조환자，차이구유통계학의의（ P＜0．05）；경수술치료후，A조환자치료적유효솔이급술후6개월ODI지수개선35분이상적인수현저고우B조，신경근손상적발생솔현저저우B조，차이구유통계학의의（ P＜0．05）。결론：소절구추판개창미창술연합요추내고정식골융합술구유수술시간단、창상경、융합솔고、회복쾌등우점，치득재림상상추엄응용。
Objective:To investigate the clinical applications of small incision fenestration minimally in-vasive surgery combined with lumbar laminectomy and fusion fixation in treatment of lumbar disc herniation with lumbar instability .Method:A total of 80 patients of lumbar disc herniation with lumbar instability were divided into two groups according to different operation .The group A had the small incision fenestration mini-mally invasive surgery combined with lumbar fixation and fusion , and the group B had the lumbar laminecto-my surgery combined with internal fixation and fusion .Result:The incision length , operative time , blood loss and bed time of the patients in group A were less than those in group B , the difference was statistically signif-icant (P <0.05);after surgery, the efficiency of the surgery and the number of patients whose ODI scores improved 35 points in group A were significantly higher than that in the group B after six months , the inci-dence of nerve root injury was lower than in group B , the difference was statistically significant ( P <0.05) . Conclusion:Small incision fenestration minimally invasive surgery combined with lumbar laminectomy and fusion fixation treatment has shorter operation time , milder trauma , higher fusion rate , quicker recovery , etc, it is worthy of clinical application .