单侧固定融合术治疗腰椎管狭窄症的效果

摘要

Objective To compare the clinical outcomes of unilateral versus bilateral pedicle screw fixation with transforaminal lumbar interbody fusion in lumbar stenosis.Methods From February 2015 to February 2016,in Zhuhai Hospital of Guangdong Hospital of Triditional Chinese Medicine,60 lumbar spinal stenosis patients were selected,according to random number table,they were divided into two groups,treatment group (30 cases) were given unilateral versus bilateral pedicle screw fixation,and control group (30 cases) were given transforaminal lumbar interbody fusion.Clinical outcomes after surgery were evaluate by JOA and VAS,meanwhile,the lumbar spine lordosis angle (LL) and the pelvic incidence Angle (PI) were measured before and after surgery.Results JOA and VAS of two groups at same time were compared,the differences were not statistically significant (P ＞ 0.05);JOA and VAS of two groups before surgery were compared with those after surgery,after surgery 3,6,12 mooths,the differences were statistically significant (P ＜ 0.05).PI,LL of two groups at same time were compared,the differences were not statistically significant (P ＞ 0.05);PI,LL of two groups before surgery were compared with those after surgery,after surgery 3,6,12 mooths,the differences were not statistically significant (P ＞ 0.05).Conclusion Compared with ransforaminal lumbar interbody fusion,unilateral pedicle screw fixation has the same safe and effective outcome.%目的 比较单侧固定融合术与传统开放腰椎融合术治疗腰椎管狭窄症的临床效果,评估单侧固定融合术治疗腰椎管狭窄症的安全性、有效性.方法 选取2015年2月～2016年2月广东省中医院珠海医院诊治的60例腰椎管狭窄症患者,采取随机数字表法分为两组,治疗组(30例)采用单侧椎弓根固定术,对照组(30例)采用传统开放腰椎融合术.采用JOA评分、VAS评分对两者患者的术后疗效进行评价;同时测量治疗前后脊柱腰椎前凸角(LL)、骨盆入射角(PI)以评估其安全性.结果 两组JOA 、VAS评分同期比较,差异无统计学意义(P＞0.05);两组JOA、VAS评分术前与术后、术后3个月、术后6个月、术后12个月比较,差异均有统计学意义(P＜0.05).两组PI、LL同期比较,差异无统计学意义(P＞0.05);两组PI、LL术前与术后、术后3个月、术后6个月、术后12个月比较,差异无统计学意义(P＞0.05).结论 与传统的开放手术相比,单侧固定融合术治疗腰椎管狭窄症,同样可以获得安全、有效的治疗效果.