摘要
目的探讨腰椎间盘突出症个性化手术策略与术式选择。方法 1998-09-2011-09手术治疗腰椎间盘突出症682例,方式如下:(1)椎板间开窗髓核摘除术492例(占72%);(2)患侧椎板间开窗髓核摘除、健侧椎板间及横突间植骨融合、椎弓根系统钉棒内固定术84例;(3)椎板开窗或椎板次全切除髓核摘除、椎体间自体骨块植骨融合、椎弓根钉棒系统内固定术70例;(4)椎板全切髓核摘除、椎间融合器cage植骨融合、椎弓根钉棒内固定术36例。结果 682例获得随访,随访时间12-48个月,平均16个月,其中:优589例,良72例,可19例,差2例,优良率:96.9%。结论个性化手术策略与术式可以防止过度手术、不合理运用脊柱内固定材料,减少病人的经济负担及并发症的发生率。
Objective To explore the surgical strategy and methods for patients with lumbar disc herniation（LDH）.Methods The clinical data of 682 patients with LDH from September 1998 to September 2011 were analyzed retrospectively.All patients were divided into four groups by individuality operation strategy.492 patients with LDH in group A were treated through nucleus pulposus discectomy.B group of 84 patients with LDH and lumbar unsteadiness was treated through dessectomy plus fusion and pedicle screw fixation systems combined with intertransverse bone fusion.70 patients in group C were treated through discectomy plus fusion and pedicle screw system combined with lumber interbody bone fusion.D group of 36 patients with recurrence of LDH and degenerative lumber spondylolisthesis was treated through discectomy plus fusion and pedicle screw system combined with interbody fusion with cage.Results All the patients were followed up for 12～48 months（average 16 months）.According to Nakai evaluating system ：excellent in 589 cases,good in 72 cases,fair in 19 cases and poor in 2 cases.The excellent and good rate was 96.9%.conclusion Rational surgical method on the basis of stenosis and physical examination and imaging examination results can reduce the incidence rate of postoperative complications and economic burden,it can avoid unnecessary operation and unreasonable pedicle internal fixation.
出处
《颈腰痛杂志》
2013年第4期327-329,共3页
The Journal of Cervicodynia and Lumbodynia
关键词
腰椎间盘突出症
腰椎不稳症
个性化手术
lumbar disc herniation
unstable cervical vertebra disease
individual operation
