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[1]魏社軍,王宇,鄭標(biāo),等.單側(cè)椎弓根螺釘內(nèi)固定結(jié)合椎間融合器植骨融合治療 相鄰雙節(jié)段腰椎間盤突出癥合并腰椎管狹窄[J].中醫(yī)正骨,2015,27(06):46-48.
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單側(cè)椎弓根螺釘內(nèi)固定結(jié)合椎間融合器植骨融合治療 相鄰雙節(jié)段腰椎間盤突出癥合并腰椎管狹窄()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年06期
頁碼:
46-48
欄目:
臨床報(bào)道
出版日期:
2015-06-30

文章信息/Info

作者:
魏社軍1王宇2鄭標(biāo)1林科1趙健甫1王鑫1俞能 寶1徐榮明3
1.浙江省杭州余杭骨科醫(yī)院,浙江 杭州 311000;
2.湖北省宜昌市第三人民醫(yī)院,湖北 宜昌 443003;
3.浙江省寧波市第六人民醫(yī)院,浙江 寧波 315040
關(guān)鍵詞:
椎間盤移位 腰椎 椎管狹窄 脊柱融合術(shù) 椎弓根螺釘 椎間融合器
摘要:
目的:探討單側(cè)椎弓根螺釘內(nèi)固定結(jié)合椎間融合器植骨融合治療相鄰雙節(jié)段腰椎間盤突出癥合并腰椎管狹窄的臨床療效和 安全性。方法:2011年8月至2013年12月收治16例相鄰雙節(jié)段腰椎間盤突出癥合并腰椎管狹窄患者,男6例,女10例。年齡30~64歲 ,中位數(shù)52.5歲。L2~3、L3~4突出2例,L3~4、L4~5突出6例,L4~ 5、L5S1突出8例。術(shù)前疼痛視覺模擬評分(visual analogue score,VAS)(7.89±0.56) 分,Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)評分(43.68±2.65)分。采用單側(cè)椎弓根螺釘內(nèi)固定結(jié)合椎間 融合器植骨融合治療,隨訪觀察臨床療效和安全性。結(jié)果:本組患者均順利完成手術(shù),置釘過程中未損傷神經(jīng)根,手術(shù)時(shí)間 (96.5±15.5)min,術(shù)中出血量(291.1±45.9)mL。所有患者均獲隨訪,隨訪時(shí)間12~30個(gè)月,中位數(shù)22.5個(gè)月。末次隨訪 時(shí)VAS評分為(2.67±0.98)分,ODI評分為(12.82±5.68)分,均較術(shù)前明顯改善(t=-18.499,P=0.000; t=- 19.694,P=0.000)。1例L4~5、L5S1突出患者術(shù)后12個(gè)月隨訪時(shí)發(fā)現(xiàn)椎間融合器內(nèi)植骨部 分吸收,但無明顯臨床癥狀; 2例L4~5、L5S1突出患者術(shù)后置于S1的螺母脫落 ,再次手術(shù)改為雙側(cè)椎弓根螺釘固定。結(jié)論:對相鄰雙節(jié)段腰椎間盤突出癥合并腰椎管狹窄患者,采用單側(cè)椎弓根螺釘內(nèi)固定結(jié)合 椎間融合器植骨融合治療,固定穩(wěn)定、植骨融合率高、腰椎功能恢復(fù)好,并發(fā)癥少,值得臨床推廣應(yīng)用。

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備注/Memo

備注/Memo:
2014-12-24收稿 2015-02-13修回
更新日期/Last Update: 2015-06-30