单侧与双侧椎弓根内固定治疗复发性腰椎间盘突出疗效比较

摘要

Objective To compare the effectiveness of unilateral pedicle and bilateral pedicle screw fixation combined with lumbar intervertebral fusion in treating the recurrence of lumbar disc herniation. Methods 39 patients with the recurrence of lumbar disc herniation were treated with unilateral pedicle ( 21 cases ) or bilateral pedicle ( 18 cases ) screw fixation and followed up. A retrospective study was performed to compare the outcomes of two methods regarding operative time,operative blood loss, the time of lumbar intervertebral fusion and complications, postoperative wound drainage,postoperative JOA scores and Macbnab function evaluation. Results 39 patients were followed up for 16~29 months. There were no significant difference between the two groups in the time of lumbar intervertebral fusion, complications, the JOA and Macbnab scores ( P>0. 05 ) . However, there were significant differences between the two groups in operative blood loss,operative time,postoperative wound drainage (P<0. 05). Conclusions In treat-ment of the recurrence of lumbar disc herniation, comparing with the bilateral pedicle screw fixation, there are a shor-ter operative time, a less operative blood loss by using unilateral pedicle screw fixation.%目的：比较单侧与双侧椎弓根内固定椎体间融合治疗复发性腰椎间盘突出的疗效。方法39例复发性腰椎间盘突出患者根据内固定方式不同分为单侧椎弓根固定组(21例)与双侧椎弓根内固定组(18例)，比较两组手术时间、术中出血量、椎体间融合时间、术后并发症、术后伤口引流量、术后JOA评分及Macbnab功能评价。结果39例均获随访，时间16~29个月。两组术后椎体间融合时间、术后并发症、术后JOA评分及Macbnab功能评价比较差异均无统计学意义(P>0．05)。两组术中出血量、手术时间、术后伤口引流量比较差异均有统计学意义(P<0．05)。结论与双侧椎弓根内固定比较，单侧椎弓根内固定手术时间短，出血量少。