摘要
背景:腰椎间盘突出症术后复发在临床上并不少见,且多数患者同时出现邻近节段的退变,再次手术较初次手术难度增加。目的:观察后路椎间植骨融合与椎弓根钉内固定修复复发性腰椎间盘突出症的6个月以上随访结果。方法:对2010年1月至2012年1月收治的随访资料完整的40例腰椎间盘突出症术后复发再次手术患者进行回顾性分析。所有二次手术均行后路椎板减压、椎间盘摘除、椎体间融合及椎弓根钉内固定。采用日本骨科学会(JOA)29分评分系统和腰痛及腰腿痛目测类比评分对患者治疗前、治疗后和末次随访时的神经功能及自觉症状进行评价,进行治疗后疗效评定并计算改善率。结果与结论:40例患者随访时间6-36个月。治疗后2个月、末次随访患者JOA评分均较治疗前显著改善,差异有显著性意义(P<0.05)。治疗后2个月、末次随访患者目测类比评分均较治疗前显著改善,差异有显著性意义(P<0.05)。提示首次手术破坏脊柱稳定性,可加速邻近节段退变,后路椎体间融合与椎弓根钉置入内固定修复复发性腰椎间盘突出症可在解决彻底减压、稳定融合、瘢痕粘连压迫等问题后,获得良好的修复效果。
BACKGROUND：Recurrent lumbar disc herniation is very common in the clinic. Most patients have adjacent segment degeneration at the same time, and second operation is more difficult than first time.
OBJECTIVE：To investigate the more than 6-month fol ow-up results of posterior interbody fusion and pedicle screw fixation in the repair of recurrent lumbar disc herniation.
METHODS：Complete fol ow-up data of 40 patients with recurrent lumbar disc herniation, who were treated from January 2010 to January 2012, were retrospectively analyzed. Al secondary surgeries received posterior laminectomy, discectomy, interbody fusion and pedicle screw fixation. Japanese Orthopaedic Association （29 scores） and low back pain Visual Analog Scale were used to assess neurological functions and rational symptoms before and after treatment and during final fol ow-up. Therapeutic effects after treatment were assessed and improvement rate was calculated.
RESULTS AND CONCLUSION：40 patients were fol owed up from 6 to 36 months. Japanese Orthopaedic Association scores were significantly improved at 2 months after treatment and during final fol ow-up compared with pre-treatment （P〈0.05）. Visual Analog Scale scores were significantly improved at 2 months after treatment and during final fol ow-up compared with pre-treatment （P〈0.05）. These data suggested that first surgery destroys stability of spine, speeds up adjacent degeneration. Posterior interbody fusion and pedicle screw fixation in the repair of recurrent lumbar disc herniation can solve some problems such as complete decompression,stable＆nbsp;integration, scar adhesion and oppression, and obtain good repair effects.
出处
《中国组织工程研究》
CAS
北大核心
2015年第9期1371-1376,共6页
Chinese Journal of Tissue Engineering Research
基金
山西省卫生厅科技攻关项目(2011009)~~
