填塞自体骨粒的Concorde脊柱微创椎间融合器经椎间孔椎体间融合治疗脱垂游离型腰椎间盘突出症

发布时间：2018-09-05 10:05

【摘要】：背景:脱垂游离型腰椎间盘突出症中突出游离于椎管内的髓核呈条索状、团块状,压迫神经根和硬膜囊,造成机体出现严重的腰腿痛和/或马尾神经损伤症状。目的:比较通道下单纯髓核摘除与通道辅助下微创经椎间孔椎体间融合并自体骨粒填塞治疗脱垂游离型腰椎间盘突出症的临床效果。方法:一项在2012年1月至2014年1月进行的回顾性研究,将收集脱垂游离型椎间盘突出症经保守治疗无效的58例患者,按照治疗方法分为通道下单纯髓核摘除组(n=36,仅进行单纯髓核摘除)和微创经椎间孔椎体间融合并自体骨粒填塞组(n=22,Concorde脊柱微创椎间融合器进行植骨融合,合并自体骨粒填塞)。结果与结论:2组患者术后1周、3个月及18个月时目测类比评分和Oswestry功能障碍指数均比术前明显下降(P0.05);微创经椎间孔椎体间融合组术后18个月腰痛目测类比评分和Oswestry功能障碍指数低于通道下单纯髓核摘除组(P0.05);2组腿痛目测类比评分接近(P0.05);通道下单纯髓核摘除组有2例术后复发。结果提示通道下单纯髓核摘除和微创经椎间孔椎体间融合并自体骨粒填塞治疗脱垂游离型腰椎间盘突出症均可取得满意的临床疗效,且微创经椎间孔椎体间融合并自体骨粒填塞在腰痛缓解方面更具有优势。
[Abstract]:Background: the nucleus pulposus protruding from the spinal canal in prolapse free lumbar intervertebral disc herniation is striped, lump, compression of nerve root and dural sac, resulting in severe lumbago and leg pain and / or cauda equina nerve injury. Objective: to compare the clinical effect of simple removal of nucleus pulposus under passage and minimally invasive intervertebral fusion via intervertebral foramen with autologous bone filling in the treatment of prolapse free lumbar intervertebral disc herniation. Methods: a retrospective study was conducted from January 2012 to January 2014 in 58 patients with prolapse of free intervertebral disc who were not treated with conservative treatment. According to the treatment method, the patients were divided into two groups: the group of pure nucleus pulposus removal (nm36) and the group of minimally invasive intervertebral fusion via intervertebral foramen and autologous granulocyte tamponade (N22 Concorde spinal fusion cage for bone graft fusion with autologous granulocyte tamponade). Results and conclusion the visual analogue score and Oswestry dysfunction index were significantly decreased at 1 week, 3 months and 18 months after operation in two groups (P0.05), visual analogies scores of low back pain in the minimally invasive intervertebral foraminal fusion group at 18 months after operation were significantly lower than those before operation (P0.05). The index of Oswestry dysfunction was lower than that of the pure nucleus pulposus removal group (P0.05). The visual analogue score of leg pain in the two groups was similar (P0.05), and there were 2 cases of recurrence after operation in the pure nucleus pulposus removal group under the channel (P0.05). The results suggested that simple removal of nucleus pulposus and minimally invasive interbody fusion through intervertebral foramen combined with autologous bone filling in the treatment of prolapse free lumbar intervertebral disc herniation could obtain satisfactory clinical effect. And minimally invasive interbody fusion through intervertebral foramen and autologous bone filling has more advantages in the relief of low back pain.
【作者单位】：南京中医药大学附属常州市中医医院骨科;
【分类号】：R687.3

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