CAJ | 학술논문

背景:经椎板关节突关节螺钉固定、椎间植骨融合治疗脊柱疾患是一种独特的固定方法,可用于退变性腰椎的融合.目的:比较采用微创经腰椎间孔椎体融合联合单侧椎弓根螺钉及经椎板关节突螺钉固定与常规开放后路腰椎体间融合术联合双侧椎弓根螺钉固定治疗下腰痛疾病的临床效果.方法:纳入2010年6月至2012年6月于武警广东总队医院就诊的腰椎间盘突出伴腰椎轻度不稳患者49例,均采用后路减压椎间融合器植骨内固定治疗.其中24例采用微创经椎间孔椎体融合术联合单侧椎弓根螺钉及经椎板关节突螺钉固定,25例采用常规开放后路腰椎体间融合术联合双侧椎弓根螺钉固定,比较两种固定方法的临床疗效.结果与结论:两种固定方法术后椎体融合率、日本矫形外科协会评分及疼痛目测类比评分改善率差异均无显著性意义(P >0.05).可见对无严重不稳的单节段退变性腰椎疾病患者,两种治疗方法的效果相当,均能有效提高椎间融合率,使小关节稳定,解除临床症状,门诊随访满意.但采用微创经椎间孔椎体融合术联合单侧椎弓根螺钉及经椎板关节突螺钉固定的患者手术切口长度、手术时间、术中出血量、术后切口引流液量明显减少(P <0.05),说明该方法具有创伤小、操作简单的优势.
배경:경추판관절돌관절라정고정、추간식골융합치료척주질환시일충독특적고정방법,가용우퇴변성요추적융합.목적:비교채용미창경요추간공추체융합연합단측추궁근라정급경추판관절돌라정고정여상규개방후로요추체간융합술연합쌍측추궁근라정고정치료하요통질병적림상효과.방법:납입2010년6월지2012년6월우무경엄동총대의원취진적요추간반돌출반요추경도불은환자49례,균채용후로감압추간융합기식골내고정치료.기중24례채용미창경추간공추체융합술연합단측추궁근라정급경추판관절돌라정고정,25례채용상규개방후로요추체간융합술연합쌍측추궁근라정고정,비교량충고정방법적림상료효.결과여결론:량충고정방법술후추체융합솔、일본교형외과협회평분급동통목측류비평분개선솔차이균무현저성의의(P >0.05).가견대무엄중불은적단절단퇴변성요추질병환자,량충치료방법적효과상당,균능유효제고추간융합솔,사소관절은정,해제림상증상,문진수방만의.단채용미창경추간공추체융합술연합단측추궁근라정급경추판관절돌라정고정적환자수술절구장도、수술시간、술중출혈량、술후절구인류액량명현감소(P <0.05),설명해방법구유창상소、조작간단적우세.
BACKGROUND: The translaminar facet joint screw fixation and interbody fusion in the treatment of spinal disorders is a unique fixation method which can be used for degenerative lumbar spinal fusion. OBJECTIVE: To observe the clinical effect of the minimal y invasive transforaminal lumbar interbody fusion combined with unilateral lumbar pedicle screw and translamina facet screw fixation versus conventional posterior lumbar interbody fusion combined with bilateral pedicle screw fixation for the treatment of low back pain. METHODS: Forty-nine patients had lumbar disc herniation with lumbar spinal mild instability were selected from Wu Jing Zong Dui Hospital of Guangdong Province between June 2010 and June 2012. Al the patients were treated with posterior decompression and interbody fusion and internal fixation. Among the 49 patients, 24 patients were treated with minimal y invasive transforaminal lumbar interbody fusion combined with unilateral lumbar pedicle screw and translamina facet screw fixation, and 25 patients were treated with conventional posterior lumbar interbody fusion combined with bilateral pedicle screws fixation. The clinical effects of the two methods above were compared. RESULTS AND CONCLUSION: There were no significant differences of vertebral fusion rate, Japanese Orthopedic Association score and visual analogue scale score between two groups (P > 0.05). These two approaches had similar clinical outcomes for single-level lumbar degenerative disorders with no instability. These two methods could effectively improve intervertebral fusion rate, make the smal joint stability, relieve clinical symptoms and make outpatient fol ow-up satisfaction. In addition the incision length, operative time, intraoperative blood loss, postoperative incision drainage of minimal y invasive transforaminal lumbar interbody fusion combined with unilateral lumbar pedicle screw and translamina facet screw fixation technology were significantly reduced (P < 0.05), and it indicated that the method had the advantages of smal trauma and simple operation.