河北医科大学学报

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模块化减压法联合植骨融合内固定治疗腰椎间盘突出症效果分析

  

  1. 河北省邯郸市中心医院骨2科，河北 邯郸 056001
  • 出版日期:2017-10-25 发布日期:2017-10-18
  • 作者简介:王瑞（1975-），男，河北武邑人，河北省邯郸市中心医院副主任医师，医学硕士，从事脊柱退行性疾病诊治研究。
  • 基金资助:
    邯郸市科学技术研究与发展计划（1123108080-2）

Analysis of therapeutic effect of modular decompression combined with internal fixation for treatment of lumbar disc herniation#br#

  1. The Second Department of Orthopedics, Handan Central Hospital, Hebei Province, Handan 056001, China
  • Online:2017-10-25 Published:2017-10-18

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摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗观察模块化减压法联合植骨融合内固定治疗腰椎间盘突出症的临床效果。
〖HTH〗方法〖HTSS〗〖KG*2〗将腰椎间盘突出症患者75例根据所采取的减压方式分为模块化减压椎间植骨融合内固定术治疗（模块化减压法组）36例和常规蚕食法减压植骨融合内固定术治疗（常规减压法组）39例。记录2组手术时间、术中出血量、并发症发生情况，分别在治疗前、治疗后3个月及末次随访时采用日本骨科协会（Japanese Orthopaedic Association,JOA）脊髓损害评分评估治疗效果，以疼痛视觉模拟评分法（Visual Analogue Scale，VAS）评定术后下腰痛发生情况。
〖HTH〗结果〖HTSS〗〖KG*2〗2组均顺利接受手术，未出现脊髓及神经损伤等情况。模块化减压法组手术时间及术中出血量均低于常规减压法组（P＜005），2组并发症发生率差异无统计学意义（P＞005）。2组术后JOA评分均呈逐渐升高趋势，时点间差异有统计学意义(P＜005），组间、组间·时点间交互作用差异无统计学意义(P＞005）；2组术后下腰痛VAS评分呈先升高再降低趋势，模块化减压法组术后下腰痛VAS评分低于常规减压法组，组间、时点间、组间·时点间交互作用差异均有统计学意义(P＜005）。
〖HTH〗结论〖HTSS〗〖KG*2〗与常规减压法相比，模块化减压法可缩短手术时间，减少出血量，减轻患者术后下腰痛的程度，有效促进神经功能恢复，是治疗腰椎椎间盘突出症的一种有效减压方法。

关键词: 椎间盘移位, 减压术, 外科, 脊柱融合术

Abstract: ［Abstract］  Objective〖HTSS〗〓To observe the clinical effect of modular decompression combined with interbody fusion in the treatment of lumbar disc herniation.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Seventyfive cases of lumbar disk hernitaion patients were divided into 2 groups based on the operation procedure they accepted. Thirtysix patients accepted modular decompression combined with interbody fusion(modular decompression group). Thirtynine patients accepted normal laminectomy combined with interbody fusion(conventional decompression group). The operative time, intraoperative blood loss, Japanese Orthopaedic Association(JOA) scores and Visual Analogue Scale(VAS) were recorded and analyzed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓No spinal cord and nerves injury occurred during the surgery. The operation time and intraoperative blood loss in modular decompression group were lower than those in conventional decompression group(P＜005). The JOA scores of the 2 groups were gradually increased when compared with the preoperation(P＜005). There was no significant difference between groups and intergroup interaction between time points(P＞005). The VAS score of lower back pain in the 2 groups were first increased and then decreased(P＜005), and modular decompression group was lower than conventional decompression group(P＜005). There was significant difference among groups, time points and intergroup interaction between time points(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Compared with the normal laminectomy, modular decompression could reduce the operation time, control the intranopative blood loss and decrease the low back pain, which is an effective decompression method for the treatment of lumbar disc herniation.

Key words: intervertebral disc displacement, decompression, surgical, spinal fusion

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