CAJ | 학술논문

背景：经皮椎弓根螺钉技术的优点在于可有效减少置钉操作对椎旁肌的过度损伤，有利于患者术后的腰背肌功能恢复，其微创技术操作可避免传统开放手术创伤大，出血多等缺陷。可折断U形长尾空心椎弓根螺钉为中空设计，撑开效果良好，内固定后应力强度、压缩时间、弯曲刚度和扭转力学性能均得到临床验证。目的：观察可折断U形长尾空心椎弓根螺钉系统置入结合小切口后路腰椎椎体间融合治疗单节段腰椎间盘突出症的临床效果。方法：纳入2012年1至12月间因腰椎间盘突出症接受可折断U形长尾空心椎弓根螺钉系统置入结合小切口后路腰椎椎体间融合治疗的患者30例。术后随访12个月，通过患者腰腿疼目测类比评分、Oswestry功能障碍指数以及影像学指标评估临床治疗效果。结果与结论：患者术前目测类比评分及Oswestry功能障碍指数分别为(7.3±0.7)分和71.4±7.1；术后第3天分别为(2.9±0.7)分和29.8±3.6，与术前相比差异有显著性意义；至术后12个月时，低水平目测类比评分及Oswestry功能障碍指数未发生显著改变。术后短时间随访发现，病例术后1年椎间融合良好，无内固定失败或感染等并发症发生。提示可折断U形长尾空心椎弓根螺钉系统置入结合小切口后路腰椎椎体间融合治疗腰椎间盘突出症的临床效果良好，椎间融合率高，手术并发症发生率低，创伤小。
배경：경피추궁근라정기술적우점재우가유효감소치정조작대추방기적과도손상，유리우환자술후적요배기공능회복，기미창기술조작가피면전통개방수술창상대，출혈다등결함。가절단U형장미공심추궁근라정위중공설계，탱개효과량호，내고정후응력강도、압축시간、만곡강도화뉴전역학성능균득도림상험증。목적：관찰가절단U형장미공심추궁근라정계통치입결합소절구후로요추추체간융합치료단절단요추간반돌출증적림상효과。방법：납입2012년1지12월간인요추간반돌출증접수가절단U형장미공심추궁근라정계통치입결합소절구후로요추추체간융합치료적환자30례。술후수방12개월，통과환자요퇴동목측류비평분、Oswestry공능장애지수이급영상학지표평고림상치료효과。결과여결론：환자술전목측류비평분급Oswestry공능장애지수분별위(7.3±0.7)분화71.4±7.1；술후제3천분별위(2.9±0.7)분화29.8±3.6，여술전상비차이유현저성의의；지술후12개월시，저수평목측류비평분급Oswestry공능장애지수미발생현저개변。술후단시간수방발현，병례술후1년추간융합량호，무내고정실패혹감염등병발증발생。제시가절단U형장미공심추궁근라정계통치입결합소절구후로요추추체간융합치료요추간반돌출증적림상효과량호，추간융합솔고，수술병발증발생솔저，창상소。
BACKGROUND:The percutaneous pedicle screw technique effectively reduces the excessive injury of screw placement on paraspinal muscles, and promotes the recovery of the function of low back muscle after surgery. Minimal y invasive technique avoids some disadvantages such as large surgical trauma and more bleeding. Folding U-shaped hol ow pedicle screw has hol ow design and good distraction effect. After fixation, stress intensity, compression time, bending stiffness and torsional mechanical properties have been verified in the clinic. OBJECTIVE:To observe the clinical effect of folding U-shaped hol ow pedicle screw fixation combined with minimal access-posterior lumbar interbody fusion for single-level lumbar disc herniation. METHODS:Between January and December 2012, folding U-shaped hol ow pedicle screw fixation with minimal access-posterior lumbar interbody fusion was performed in 30 patients with lumbar disc herniation. The mean fol ow-up period was 12 months. Lumbago Visual Analog Scale, Oswestry Disability Index and imaging indicators were utilized to evaluate clinical therapeutic effects. RESULTS AND CONCLUSION:Preoperative Visual Analog Scale pain score and Oswestry Disability Index for al patients were 7.3±0.7 and 71.4±7.1, 2.9±0.7 and 29.8±3.6 at 3 days after surgery, showing significant differences. At 12 months, no significant difference in Visual Analog Scale pain score and Oswestry Disability Index was detected. Postoperative short-period fol ow-up demonstrated that al lumbar interbody fusion was achieved in one year. There was no complication such as implant failure or infection. These findings indicated that folding U-shaped hol ow pedicle screw fixation with minimal access-posterior lumbar interbody fusion for lumbar disc herniation showed good clinical therapeutic effects, high rate of interbody fusion and a low rate of complications and smal trauma.