摘要
目的了解复杂腰椎管狭窄症患者行椎间盘镜(Micro Endo Disc System,MED)下单侧开窗双侧减压椎体间融合术对脊柱功能及疼痛情况的影响。方法选取我院2014-02-2015-02需行MED下单侧开窗双侧减压椎体间融合术的腰椎管狭窄症患者64例作为研究对象,了解患者术前术后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数问卷表(ODI)及术后影像学脊柱情况。结果 64例患者均未发生神经损伤,在术后影像学检查中,正侧位X线片内未见植物断裂或松动,内固定位置良好,脊柱序列得到改善,减压充分。术后3个月与末次随访时患者ODI、VAS腰痛、VAS腿痛评分均显著低于术前,差异有统计学意义(F=255.72,F=582.38,F=3007.58,P<0.05)。术后3个月与末次随访时患者椎间隙高度、Cobb角、滑脱比均显著低于术前,差异有统计学意义(F=6.53,F=18.01,F=5.28,P<0.05)。结论复杂腰椎管狭窄症患者行MED下单侧开窗双侧减压椎体间融合术可有效缓解患者临床症状,减轻疼痛程度,改善脊柱功能,术后疗效较好。
Objective To investigate the effect of unilateral fenestration and bilateral decompression interbody fusion under MED（diskoscope）on pain and spinal function in patients with lumbar spinal stenosis. Methods From February 2014 to February 2015, 64 patients of lumbar spinal stenosis with unilateral fenestration and bilateral decompression interbody fusion under MED in our hospital were selected in the research. The preoperative and postoperative visual analogue scale （VAS）, Oswestry disability index（ODI）questionnaire and postoperative spine imaging condition were investigated. Results There were no nerve injuries in 64 cases. The postoperative imaging examination showed that no implant rupture or loosening in positive X-ray film, the internal fixation location was good, the spine sequence was improved and the decompression was sufficient. The ODI, VAS backache, VAS leg pain scores at 3 months after operation and the last follow-up were significantly lower than before surgery, the differences were statistically significant（F=255.72, F=582.38, F=3007.58, P〈0.05）. At 3 months after operation and the last follow-up, the height of the intervertebral space, Cobb angle and the ratio of spondylolisthesis were significantly lower than before operation, the differences were statistically significant（F=6.53, F=18.01, F=5.28, P〈0.05）. Conclusion Unilateral fenestration and bilateral decompression interbody fusion under MED adopted for patients with lumbar spinal stenosis can effectively alleviate the clinical symptoms and pain, improve the spinal function simultaneously with impressive postoperative curative effect.
作者
郭存
李红霞
牛培鸿
GUO Cun;LI Hong-xia;NIU Pei-hong(Department of Orthopaedics,General hospital of Jinshui District,Zhengzhou,Henan,450000,China)
出处
《颈腰痛杂志》
2018年第4期416-418,共3页
The Journal of Cervicodynia and Lumbodynia
关键词
腰椎管狭窄
减压术
脊柱融合术
lumbar spinal stenosis
decompression
spinal fusion
