开窗髓核摘除联合椎间支点植骨术治疗腰椎间盘突出症

Clinical application of vertebral lamia fenestration and pivot point bone graft for lumbar disc herniation

摘要:

目的 探讨开窗髓核摘除联合椎间支点植骨术治疗腰椎间盘突出症的临床疗效。方法 选取2010年 1月—2012年12月河南洛阳正骨医院脊柱外科收治的42例腰椎间盘突出症患者采用开窗髓核摘除联合椎间支点植骨术治疗。疗效评定依据疼痛视觉模拟评分（VAS）和Oswestry功能障碍指数（ODI）。患者术前及术后随访时二维CT片对椎间隙高度、椎间植骨块长度和直径比较，评价手术疗效。用Bridwell方法评价腰椎融合情况。结果 42例患者均获得随访，随访时间12～48个月。术后48个月下肢疼痛VAS及ODI较术前减低，差异有统计学意义（P?<0.05）。术后不同时间点椎间隙高度、植骨柱长度和直径较术前比较无差异（P?> 0.05）。末次随访，根据Bridwell腰椎间融合评价标准，Ⅱ和Ⅲ级37例（88%）。所有患者无永久性神经根损伤、无大血管损伤和硬膜囊撕裂等并发症。结论 开窗单纯髓核摘除联合椎间支点植骨术治疗腰椎间盘突出症手术简单、费用低、临床疗效好、而且可保留椎间盘突出节段活动度。

Abstract:

Objective To investigate the clinical application of vertebral lamia fenestration and pivot point bone graft for lumbar disc herniation. Methods A total of 42 patients with lumbar disc herniation were admitted into our hospital between January 2010 and December 2012 for surgical therapy. Visual analogue pain scores (VAS) and Oswestry Disability Index (ODI) were recorded. Disc height, bone graft length and diameter were noted for evaluation of surgical efficacy. Bridwell method was used to evaluate lumbar fusion. Results Totally 42 patients were followed ranging from 12 to 48 months. Novel operation induced a significant decrease of VAS score ODI index at time of 48 months after operation when compared with those prior to surgery, (P?