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经皮椎间孔镜下髓核摘除术联合纤维环缝合术治疗腰椎间盘突出症的疗效观察

Preliminary efficacy of inter-spinal distraction fusion which is a new technique for lumbar disc herniation.

机构信息

Department of Orthopaedic Surgery, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China.

Department of Orthopaedic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.

出版信息

Int Orthop. 2019 Apr;43(4):899-907. doi: 10.1007/s00264-018-4188-0. Epub 2018 Oct 23.

Abstract

INTRODUCTION

To investigate the short- and medium-term efficacy of inter-spinal distraction fusion (ISDF) for lumbar disc herniation with a spinal internal fixation device, the BacFuse Spinous Process Fusion Plate.

METHODS

Ninety-five patients who received ISDF between January 2014 and January 2015 were included for the current retrospective study. The symptoms and imaging results before surgery, immediately after surgery, at six months, and at the last follow-up were assessed using the leg visual analogue scale (VAS), Oswestry disability index (ODI), and 12-item short-form survey (SF-12). The intra-operative intervertebral angle (IA), anterior disk height (ADH), posterior disk height (PDH), foramina height (FH), foramina width (FW), and range of motion (ROM) were assessed using X-rays. The foramina and herniated disc area were assessed using computed tomography (CT).

RESULTS

The leg VAS, ODI, and SF-12 were significantly improved after surgery. All indices except ADH were also significantly improved after surgery. PDH and FH increased by 15.5% (P < 0.001) and 9.7% (P < 0.001) at the last follow-up. ROM was statistically different from before surgery. CT images indicated that the herniated disc area decreased by 3.1%, while the foramina areas increased by 5.7% at the last follow-up. 92.6% patients demonstrated successful outcome.

CONCLUSIONS

ISDF significantly alleviated the clinical symptoms, improved spinal structure, and partially retracted the herniated disc. Our findings imply that ISDF is an effective minimally invasive procedure in the treatment of lumbar disc herniation.

摘要

介绍

为了研究脊柱内固定装置 BacFuse 棘突融合板(BacFuse Spinous Process Fusion Plate)治疗腰椎间盘突出症的短期和中期疗效,我们对接受 ISDF 的 95 例患者进行了回顾性研究。使用腿部视觉模拟量表(VAS)、Oswestry 残疾指数(ODI)和 12 项简明健康调查量表(SF-12)评估术前、术后即刻、术后 6 个月和末次随访时的症状和影像学结果。采用 X 射线评估术中椎间角(IA)、前间盘高度(ADH)、后间盘高度(PDH)、椎间孔高度(FH)、椎间孔宽度(FW)和活动度(ROM)。采用 CT 评估椎间孔和椎间盘突出面积。

结果

术后腿部 VAS、ODI 和 SF-12 显著改善。除 ADH 外,所有指标在术后均显著改善。末次随访时 PDH 和 FH 分别增加 15.5%(P<0.001)和 9.7%(P<0.001)。ROM 与术前相比有统计学差异。CT 图像显示,术后末次随访时椎间盘突出面积减少 3.1%,椎间孔面积增加 5.7%。92.6%的患者获得了成功的结果。

结论

ISDF 显著缓解了临床症状,改善了脊柱结构,并部分回缩了椎间盘。我们的发现表明 ISDF 是治疗腰椎间盘突出症的一种有效微创方法。

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