CAJ | 학술논문

背景：极外侧腰椎间盘突出症是临床上比较少见的一种腰椎间盘突出类型，目前的治疗方法多样，但治疗效果和复发率报道不一。 　　目的：探讨应用腰椎椎弓根钉棒内固定联合椎间融合器置入椎间融合修复极外侧型腰椎间盘突出症的临床效果。 　　方法：回顾性分析2006年3月至2009年1月行腰椎椎弓根钉棒系统联合椎间融合器置入椎间融合治疗的19例极外侧型腰椎间盘突出症患者的临床资料，根据目测类比评分标准及Macnab评价标准进行疗效判定，观察治疗后腰椎稳定性，通过数据库文献检索方法评估腰椎椎弓根钉棒内固定联合椎间融合器置入椎间融合修复极外侧型腰椎间盘突出症的效果。 　　结果与结论：19例患者均得到随访，随访时间13个月-3年。所有患者治疗后即有下肢及腰部疼痛不同程度的缓解，治疗前目测类比评分为(7.3±1.3)分，治疗后为(2.1±0.8)分，差异有显著性意义(P <0.05)。根据Macnab评价标准，优15例，良3例，可1例，差0例，优良率为95%。所有患者均未发生断钉、断棒及松动现象，所有椎间融合器均达到融合，未发生继发性腰椎管狭窄。提示腰椎椎弓根钉棒系统内固定联合椎间融合器置入椎间融合修复极外侧型腰椎间盘突出症症状缓解快，内固定牢固，可获得良好的腰椎稳定性。
배경：겁외측요추간반돌출증시림상상비교소견적일충요추간반돌출류형，목전적치료방법다양，단치료효과화복발솔보도불일。 　　목적：탐토응용요추추궁근정봉내고정연합추간융합기치입추간융합수복겁외측형요추간반돌출증적림상효과。 　　방법：회고성분석2006년3월지2009년1월행요추추궁근정봉계통연합추간융합기치입추간융합치료적19례겁외측형요추간반돌출증환자적림상자료，근거목측류비평분표준급Macnab평개표준진행료효판정，관찰치료후요추은정성，통과수거고문헌검색방법평고요추추궁근정봉내고정연합추간융합기치입추간융합수복겁외측형요추간반돌출증적효과。 　　결과여결론：19례환자균득도수방，수방시간13개월-3년。소유환자치료후즉유하지급요부동통불동정도적완해，치료전목측류비평분위(7.3±1.3)분，치료후위(2.1±0.8)분，차이유현저성의의(P <0.05)。근거Macnab평개표준，우15례，량3례，가1례，차0례，우량솔위95%。소유환자균미발생단정、단봉급송동현상，소유추간융합기균체도융합，미발생계발성요추관협착。제시요추추궁근정봉계통내고정연합추간융합기치입추간융합수복겁외측형요추간반돌출증증상완해쾌，내고정뢰고，가획득량호적요추은정성。
BACKGROUND:Extreme lateral lumbar disc herniation is a rare type of lumbar disc herniation, there are a variety of treatment methods, but the therapeutic efficacy and recurrence rate are controversial. OBJECTIVE:To investigate the availability of lumbar pedicle screw fixation combined with interbody fusion cage for treating extreme lateral lumbar disc herniation. METHODWe retrospectively analyzed 19 patients with extreme lateral lumbar disc herniation after treatment with lumbar pedicle screw fixation combining with interbody fusion cage from March 2006 to January 2009. The outcomes were evaluated depending on VAS scoring standard and Macnab scoring standard, lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after lumbar pedicle screw fixation combined with interbody fusion cage depending on literature search. RESULTS AND CONCLUSION:Al the 19 patients were fol owed up for 13 months to 3 years, the leg and lumbar pain of al the patients were relieved to varying degrees. Preoperative VAS score was 7.3±1.28 points and postoperative VAS score was 2.1±0.8 points, showing significant difference between two groups (P<0.05). The excellent and good rate was up to 95%with 15 excellent results, 3 good results and 1 acceptable result depending on Macnab evaluation standard. There was no pedicle screw loosening, broken, non-fusion phenomenon. Al the lumbar interbody fusions were good. No one occurred secondary lumbar spinal stenosis. Experimental findings indicate that, lumbar pedicle screw fixation combined with interbody fusion cage for extremely lateral lumbar disc herniation, is characterized as fast symptom relief, strong fixation and good lumbar stability.