摘要
背景:腰椎退变性疾病的患者经保守治疗无效,感觉运动功能障碍、马尾综合征,疼痛难忍而影响工作和生活的情况,需要通过手术的方法来治疗。目的:分析腰椎退变性疾病的植入物置入内固定治疗效果,深入了解腰椎退变性疾病患者的临床症状检查方法,回顾腰椎退变性疾病采用植入物置入内固定治疗的相关文献。方法:选取2010年12月29日至2011年1月27日在解放军第306医院骨科治疗的腰椎滑脱合并相邻节段和/或跳跃性节段退变性疾病的患者23例,在全麻下行后路腰椎管减压椎间融合器植入植骨融合椎弓根螺钉系统内固定,采用VAS、JOA和ODI评分对患者术前和术后进行评定,加用临床症状改善程度作为手术疗效的判定标准。并检索腰椎退变性疾病采用植入物置入内固定治疗的相关研究文献,对文献的实验方法和实验结果进行深入分析。结果与结论:采用短节段选择性责任节段经椎弓根螺钉系统内固定,只固定单一节段,手术创伤小,安全性大,功能受限少。患者术后半年随访JOA评分改善率为80.3%。腰椎退变性疾病患者临床症状检查方法包括Babinski征、Kernig征、"4"字试验、股神经牵拉试验和腰椎稳定性Posner诊断等,可以用来判断患者症状严重程度。后路腰椎管减压椎间融合器植入植骨融合椎弓根螺钉系统内固定可以有效改善椎体三维稳定性,疗效显著。
BACKGROUND： The patients with lumbar disc herniation who have no relief after conservative treatment, sensorimotor dysfunction, cauda equina syndrome, unbearable pain and have impact on the work and life should be treated with operation. OBJECTIVE： To analyze the effect of internal fixation on the treatment of lumbar disc herniation, in-depth explore the clinical examination method of lumbar disc herniation, and to review the literatures on the treatment of lumbar disc herniation with internal fixation. METHODS： Twenty-three patients with lumbar disc herniation and L5/$1 spondylolisthesis were selected from the Department of Orthopedics, the 306th Hospital of PLA during 29 December 2010 to 27 January 2011, and the patients received posterior lumbar canal decompression and interbody fusion plus pedicle screw system internal fixation after general anesthesia, the Japanese Orthopaedic Association Scores was used to assess before and after operation, and the clinical improvement degree was considered as the surgical treatment criteria. The literatures on the treatment of lumbar disc herniation with internal fixation were screened out, and the experimental methods and results were in-depth analyzed. RESULTS AND CONCLUSION： The patients treated with short-segment pedicle screw system internal fixation have the advantages of little surgical trauma, more safety and small functional limitation as it just fix single segment. The follow-up results at 6 months after operation showed that improvement rate of Japanese Orthopaedic Association Scores was 80.3%Clinical examination methods of lumbar disc herniation including Babinski sign, Kernig sign, Patrick sign, femoral nerve tension test and Posner diagnosis of lumbar spine stability, these methods can be used to diagnose the severity of the patient＇s symptoms. Posterior lumbar canal decompression and interbody fusion plus pedicle screw system internal fixation can effectively improve the three-dimensional stability of vertebral body, and has a significant effect.
出处
《中国组织工程研究》
CAS
CSCD
2012年第44期8340-8347,共8页
Chinese Journal of Tissue Engineering Research
