CAJ | 학술논문

目的：探讨在 MastQuadrantTM 可扩张管通道系统下单侧固定加 Cage 治疗腰椎间盘突出症伴腰椎不稳的临床疗效。方法对31例腰椎间盘突出症伴腰椎不稳患者，采用 Quadrant 微创下单侧固定加 Cage 椎间融合术治疗，其中男20例，女11例；年龄34~76岁。术前、术后采用日本骨科学会（Japanese orthopaedic association，JOA）腰背痛评分及 Oswestry 功能障碍指数（oswestry disability index，ODI）进行评分，根据 X 线片评价椎间隙高度变化及椎间融合情况。结果31例患者经14~36个月随访。本组患者腰部及下肢症状完全缓解，术后3 d 下地行走，椎间高度无丢失，影像学上椎间融合率100%，临床疗效据日本 JOA 评分，由术前（7.6±2.5）分上升至末次随访时（25.7±1.4）分，治疗改善率末次为84.46%，ODI 评分由术前（55.5±5.2）分下降至末次随访的（10.9±3.0）分。结论 Quadrant 微创下单侧固定 Cage 椎间融合治疗腰椎间盘突出伴腰椎不稳能获得满意疗效。
목적：탐토재 MastQuadrantTM 가확장관통도계통하단측고정가 Cage 치료요추간반돌출증반요추불은적림상료효。방법대31례요추간반돌출증반요추불은환자，채용 Quadrant 미창하단측고정가 Cage 추간융합술치료，기중남20례，녀11례；년령34~76세。술전、술후채용일본골과학회（Japanese orthopaedic association，JOA）요배통평분급 Oswestry 공능장애지수（oswestry disability index，ODI）진행평분，근거 X 선편평개추간극고도변화급추간융합정황。결과31례환자경14~36개월수방。본조환자요부급하지증상완전완해，술후3 d 하지행주，추간고도무주실，영상학상추간융합솔100%，림상료효거일본 JOA 평분，유술전（7.6±2.5）분상승지말차수방시（25.7±1.4）분，치료개선솔말차위84.46%，ODI 평분유술전（55.5±5.2）분하강지말차수방적（10.9±3.0）분。결론 Quadrant 미창하단측고정 Cage 추간융합치료요추간반돌출반요추불은능획득만의료효。
Objective To explore the clinical outcome of the minimally invasive surgical approach by mast Quadrant sys-tem in the treatment of lumbar disc herniation with lumbar spinal instability. Methods For 31 patients with single level lum-bar disc herniation with lumbar spinal instability which diagnosed by magnetic resonance imaging and dynamic X-rays. This group included 20 males and 11 females. All patients were managed by unilateral pedicle screw fixation and interbody fusion under Mast Quadrant system. We evaluate the therapeutic effect according to Japanese Orthopaedic Association(JOA)and Os-westry disability index(ODI)before and after surgery. X-rays was used to evaluate the height variation and fusion of interverte-bral space. Results All patients were followed up for 14 to 36 months,with a mean period of 20. 4 months. The symptoms of lumbar and lower extremity were relieved completely. There was no decrease of intervertebral height. Radiographic interbody fu-sion rate was 100% . According to JOA scoring,the score increased from(7. 6 ± 2. 5)before operation to(25. 7 ± 1. 4)in the last follow-up,improvement rate of treatment was 84. 46% ,the score of ODI decreased from(55. 5 ± 5. 2)to(10. 9 ± 3. 0)in the last follow up after surgery. Conclusion The minimally invasive surgical treatment of unilateral pedicle screw fixation and interbody fusion assisted mast Quadrant system for lumbar disc herniation with lumbar spinal instability is reliable and provides satisfactory lumbar fusion and clinical results.