CAJ | 학술논문

目的：：探讨应用改良TLIF技术结合后路经椎弓根钉棒内固定、椎间融合器( BAK)植骨融合术治疗脱出型腰椎间盘突出症并腰椎不稳症。方法：应用改良TLIF技术结合后路椎弓根钉棒椎间融合器植骨融合术治疗65例腰痛并单侧下肢根性疼痛的脱出型腰椎间盘突出症并腰椎不稳症病人,术前和术后对病人进行视觉疼痛评分( visual analogue pain score,VAS),椎间系角度、整个腰椎前凸角度、椎间隙后缘高度测量和手术满意度问卷调查,评价治疗效果。结果：随访12~36mo,平均22mo。术前VAS和椎间系角度整个腰椎前凸角度椎间隙后缘高度,分别是7.8±1.8分和3.4±0.3°、40±0.6°、8±0.5mm,随访时为2.9±1.2分(P=0.0082,P<0.01)和12.6±0.4°(P=0.0075,P<0.01)、52°±0.5°(P=0.0061,P<0.01)、12±0.3mm(P=0.0054,P<0.01)。65例病人中60例手术满意度问卷调查高于40分(92.3%)认为手术效果优良。没有发生因操作不当及器械问题引起的并发症。结论：后路改良TLIF技术结合经椎弓根钉棒内固定、椎间融合器植骨融合术是一种安全有效的治疗脱出型腰椎间盘突出症并腰椎不稳症的手术方法。
목적：：탐토응용개량TLIF기술결합후로경추궁근정봉내고정、추간융합기( BAK)식골융합술치료탈출형요추간반돌출증병요추불은증。방법：응용개량TLIF기술결합후로추궁근정봉추간융합기식골융합술치료65례요통병단측하지근성동통적탈출형요추간반돌출증병요추불은증병인,술전화술후대병인진행시각동통평분( visual analogue pain score,VAS),추간계각도、정개요추전철각도、추간극후연고도측량화수술만의도문권조사,평개치료효과。결과：수방12~36mo,평균22mo。술전VAS화추간계각도정개요추전철각도추간극후연고도,분별시7.8±1.8분화3.4±0.3°、40±0.6°、8±0.5mm,수방시위2.9±1.2분(P=0.0082,P<0.01)화12.6±0.4°(P=0.0075,P<0.01)、52°±0.5°(P=0.0061,P<0.01)、12±0.3mm(P=0.0054,P<0.01)。65례병인중60례수술만의도문권조사고우40분(92.3%)인위수술효과우량。몰유발생인조작불당급기계문제인기적병발증。결론：후로개량TLIF기술결합경추궁근정봉내고정、추간융합기식골융합술시일충안전유효적치료탈출형요추간반돌출증병요추불은증적수술방법。
Objective:To investigate the application of improved technology TLIF combined passing pedicle screw fixation,interbody fusion( BAK) to treat prolapse of lumbar disc herniation and lumbar instability. Methods:Application of improved technology TLIF combined with posterior pedicle screw and interbody fusion and fusion treat 65 cases of low back paln and radicular paln with unilateral lower limb prolapse of lumbar disc herniation and lumbar instability patients, the patients were examined visual analogue paln score ( VAS ) before and after operation, to survey department of intervertebral angle,the whole lumbar lordosis angle,the edge of the disc space height measurement and surgical sat-isfaction,to evaluate the therapeutic effect. Results:To follow-up 12 ~36mo, 22mo average. VAS before operation and the department of intervertebral angle, whole lumbar lordosis angle and Intervertebral height of the tralling edge,respectively,7. 8±1. 8 points and 3. 4±0. 3°,40±0. 6°,8±0. 5 mm,the first check:2.9±1.2 points(P=0.0082,P<0.01)and 12.6±0.4°(P=0.0075,P<0.01)、52°±0. 5°(P=0. 0061,P<0. 01),12±0. 3mm(P=0. 0054,P<0. 01). Among 65 patients,60 cases surgery satisfaction survey more than 40 points ( 92 . 3%) , and they considered excellent surgical results. Complication of improper operation and Equipment problems didn ’ t happen. Conclusion:posterior improved technology TLIF combines with the pedicle screw fixation、 interbody fusion and fusion surgery is a safe and effective surgical methods to treat Prolapse Dype Lumbar Disc Herniation and lumbar instability.