【摘要】：背景:脫垂游離型腰椎間盤突出癥中突出游離于椎管內(nèi)的髓核呈條索狀、團(tuán)塊狀,壓迫神經(jīng)根和硬膜囊,造成機(jī)體出現(xiàn)嚴(yán)重的腰腿痛和/或馬尾神經(jīng)損傷癥狀。目的:比較通道下單純髓核摘除與通道輔助下微創(chuàng)經(jīng)椎間孔椎體間融合并自體骨粒填塞治療脫垂游離型腰椎間盤突出癥的臨床效果。方法:一項(xiàng)在2012年1月至2014年1月進(jìn)行的回顧性研究,將收集脫垂游離型椎間盤突出癥經(jīng)保守治療無效的58例患者,按照治療方法分為通道下單純髓核摘除組(n=36,僅進(jìn)行單純髓核摘除)和微創(chuàng)經(jīng)椎間孔椎體間融合并自體骨粒填塞組(n=22,Concorde脊柱微創(chuàng)椎間融合器進(jìn)行植骨融合,合并自體骨粒填塞)。結(jié)果與結(jié)論:2組患者術(shù)后1周、3個(gè)月及18個(gè)月時(shí)目測類比評(píng)分和Oswestry功能障礙指數(shù)均比術(shù)前明顯下降(P0.05);微創(chuàng)經(jīng)椎間孔椎體間融合組術(shù)后18個(gè)月腰痛目測類比評(píng)分和Oswestry功能障礙指數(shù)低于通道下單純髓核摘除組(P0.05);2組腿痛目測類比評(píng)分接近(P0.05);通道下單純髓核摘除組有2例術(shù)后復(fù)發(fā)。結(jié)果提示通道下單純髓核摘除和微創(chuàng)經(jīng)椎間孔椎體間融合并自體骨粒填塞治療脫垂游離型腰椎間盤突出癥均可取得滿意的臨床療效,且微創(chuàng)經(jīng)椎間孔椎體間融合并自體骨粒填塞在腰痛緩解方面更具有優(yōu)勢。
[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.
【作者單位】： 南京中醫(yī)藥大學(xué)附屬常州市中醫(yī)醫(yī)院骨科;
【分類號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉豐平;趙紅衛(wèi);陳海丹;羅茗刈;;TESSYS椎間孔鏡治療腰椎間盤突出癥的學(xué)習(xí)曲線及經(jīng)驗(yàn)[J];中國矯形外科雜志;2016年03期

2 張偉彬;陳揚(yáng);楊欣建;錢文彬;楊澤雨;夏曉龍;藍(lán)濤;;微創(chuàng)經(jīng)椎間孔腰椎椎間融合術(shù)與PLIF治療單節(jié)段腰椎間盤突出癥的臨床療效比較[J];中國骨與關(guān)節(jié)損傷雜志;2016年01期

3 嚴(yán)小虎;楊紅勝;曹宗銳;常山;隋w，

本文編號(hào)：2223952