单侧椎弓根螺钉固定联合TLIF行腰椎融合术的中期疗效

发布时间：2019-08-13 13:22

【摘要】：[目的]比较单侧与双侧椎弓根螺钉固定联合经椎间孔椎间融合术(TLIF)治疗腰椎退行性疾病的中期临床疗效。[方法]回顾性分析2009年5月~2010年12月采用单侧或双侧椎弓根螺钉联合经椎间孔椎间融合术治疗59例腰椎退行性疾病患者,其中单侧固定27例,双侧固定32例,对两组患者的手术时间、出血量、住院时间和住院费用等进行比较,采用Oswestry功能障碍指数评分(ODI)评价疗效,通过影像学评估椎体间融合情况及邻近椎间盘退变情况。[结果]所有患者获5年以上随访。单侧组在手术时间、出血量等指标上优于双侧组(P0.05)。术前,术后3、12个月ODI评分单侧固定与双侧固定差异无统计学意义(P0.05),但术后5年ODI评分比较差异有统计学意义(P0.05)。融合率单侧固定与双侧固定差异无统计学意义(P0.05)。影像学检查相邻节段退变单侧固定较双侧固定发生率低(P0.05)。[结论]单侧或双侧椎弓根螺钉联合经椎间孔椎间融合术治疗腰椎退行性疾病均能获得满意的疗效,单侧固定在降低邻椎病具有潜在优势。
[Abstract]:[objective] to compare the medium-term clinical efficacy of unilateral and bilateral pedicle screw fixation combined with intervertebral foramen interbody fusion (TLIF) in the treatment of lumbar degenerative diseases. [methods] from May 2009 to December 2010, 59 patients with lumbar degenerative diseases were treated with unilateral or bilateral pedicle screws combined with intervertebral foramen interbody fusion, including 27 patients with unilateral fixation and 32 patients with bilateral fixation. The operation time, blood loss, hospitalization time and hospitalization cost of the two groups were compared, and the curative effect was evaluated by Oswestry dysfunction index score (ODI). The interbody fusion and adjacent intervertebral disc degeneration were evaluated by imaging. [results] all patients were followed up for more than 5 years. The operation time and blood loss in unilateral group were better than those in bilateral group (P 0.05). Before operation, 3 months after operation, 12 months after operation, there was no significant difference in ODI score between unilateral fixation and bilateral fixation (P 0.05), but there was significant difference in ODI score 5 years after operation (P 0.05). There was no significant difference in fusion rate between unilateral fixation and bilateral fixation (P 0.05). The incidence of unilateral fixation in adjacent segment degeneration was lower than that in bilateral fixation (P 0.05). [conclusion] unilateral or bilateral pedicle screw combined with intervertebral foramen interbody fusion can achieve satisfactory results in the treatment of lumbar degenerative diseases. Unilateral fixation has potential advantages in reducing adjacent vertebral diseases.
【作者单位】：浙江省金华市中心医院骨科;
【分类号】：R687.3

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