摘要
[目的]评价不同的手术方式治疗腰椎间盘突出症单纯髓核摘除术后复发的长期疗效。[方法]从2001年5月～2005年8月手术治疗74例单纯髓核摘除术后腰突症复发的患者,将患者分成3组:全椎板切除髓核摘除组,后外侧融合组和后路椎间融合组,经过长期随访(≥2年),复习其临床资料,比较各组间的下腰痛JOA评分改善率,椎间高度下降率以及上一椎间隙角的改变率,从而比较不同术式的长期疗效。[结果]全椎板切除髓核摘除术、后外侧融合术和后路椎间融合术JOA评分改善率依次增高,与全椎板切除髓核摘除组相比后外侧融合组不能减少椎间高度的降低,同时上一节段的椎间隙角度改变率与未融合组相似,而PLIF组在维持椎间高度的同时,上一节段的椎间隙角度改变率明显小于前两组。[结论]治疗腰椎间盘突出症复发,在提高下腰痛评分、维持椎间高度和上一椎间隙角度方面,后路椎间融合术优于其它两种手术方式。
[ Objective] To evaluate the long- term results of recurrent lumbar disc herniation between different kinds of reoperation. [ Method] Seventy -four patients of recurrent lumbar disc herniation after discectomy alone were treated surgically from May 2001 to Augest 2005. They were divided into three groups： nonfusion, posterolateral fusion and intervertebral fusion. After a long term follow -up （≥2y） , their clinical data were reviewed to compared their improvement rate of lower back pain, JOA score , subside rate of disc height and chang rate of superior intervertebral space angle. [ Result] The long -term results revealed that the improvement rates of lower back pain JOA score in the three groups were increased in sequence. The differences in subside rate of disc height and change rate of superior intervertebral space angle between discectomy and posterolateral fusion groups were insignificant, but much higher than those of posterior lumbar interbody fusion group. [ Conclusion ] Posterior lumbar interbody fusion is effective in increasing the improvement rates of lower back pain JOA score and maintaining the disc height and the superior intervertebral space angle.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2009年第3期183-186,共4页
Orthopedic Journal of China
