腰椎间融合单侧及双侧内固定术对腰椎间盘突出症的疗效对比探究

摘要

目的：对比腰椎间融合单侧及双侧内固定术对腰椎间盘突出症的疗效，探究更为有效、可靠的治疗方式。方法：选取腰椎间盘突出症患者112例，按照手术方式不同随机将其分为单侧组及双侧组，每组56例，分别采取腰椎间融合单侧或双侧内固定治疗，对比两组患者的手术情况及治疗效果。结果：单侧组手术时间、术中出血量及住院费用低于双侧组，差异有统计学意义(t=8.857，t=9.620，t=12.338；P＜0.05)；两组住院时间比较无明显差异；两组患者治疗后疼痛视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI)均显著下降(t=28.223，t=24.899，t=25.013， t=20.475；P＜0.05)，其治疗前后VAS及ODI组间对比均无明显差异；两组患者均获得有效随访，单侧组末次随访椎间融合率为89.3%，双侧组椎间融合率为92.9%；单侧组随访未见明显并发症，双侧组随访发现1例椎间融合器内植骨部分吸收，1例出现突出对侧根性症状。结论：腰椎间单侧及双侧内固定均能够有效改善患者腰椎间盘突出症疼痛症状，且具有良好的椎间融合度，安全性较高；而单侧内固定手术时间更短、出血量更少且患者负担更小，对于需手术治疗的严重腰椎间盘突出症患者可使用腰椎间融合单侧内固定治疗。%Objective:To compare lumbar fusion effect of unilateral and bilateral internal fixation for lumbar disc herniation, to explore more effective, reliable treatment. Methods:112 cases of lumbar selects my courtyard 2007 April-2010 year in April admitted to the disc herniation were randomly grouped, unilateral group and bilateral group with 56 cases in each group, respectively, to take unilateral or bilateral internal fixation for the treatment of lumbar fusion operation, compared two groups of patients and the therapy effect. Results:the unilateral group operation time, amount of bleeding during the operation and hospitalization expenses below the bilateral group, there was significant difference(t=8.857, t=9.620, t=12.338;P<0.05), the two groups had no significant difference (P>0.05);the two group patients after VAS and ODI were significantly decreased (P<0.05), before and after the treatment of VAS and ODI the comparison between the two groups were not statistically significant difference (P>0.05);the unilateral group at the end of the follow-up of 50 cases of intervertebral fusion, the fusion rate was 96.2%, the bilateral group interbody fusion in 52 cases, the fusion rate was 100%, two groups of patients at the end of the follow-up intervertebral fusion rate has no obvious statistical difference (x2=0.372, P<0.05);unilateral group were no significant complications, bilateral group were found 1 cases of intervertebral fusion device implant bone absorption, 1 cases highlight the root symptoms, complication rate was 3.8%, the two groups of patients with complications were no significant statistical difference. Conclusion:Lumbar unilateral and bilateral internal fixation can effectively improve the patients with lumbar disc herniation pain symptoms, and has good fusion degree, high security, and unilateral internal fixation operation time is shorter, less blood loss and the burden of patients is smaller, need operation treatment for severe lumbar disc herniation, fusion and unilateral internal fixation for the treatment of recommend the use of lumbar.