Zhang Li, Huang Ai-E
Department of Spinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical Univercity, Zhangzhou 363000, Fujian, China;
Department of Spinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical Univercity, Zhangzhou 363000, Fujian, China.
Zhongguo Gu Shang. 2019 Mar 25;32(3):220-224. doi: 10.3969/j.issn.1003-0034.2019.03.005.
To explore the clinical effect of unilateral screw fixation and lumbar interbody fusion under the Quadrant tunnel to treat prolapsed lumbar disc herniation in young patients.
Between January 2015 and January 2017, 18 young patients with prolapsed lumbar disc herniation were treated with unilateral pedicle screw fixation and lumbar interbody fusion under Quadrant tunnel. Among them, there were 10 males and 8 females, aged from 20 to 28 years old with an average of 22.5 years. The VAS, lumbar JOA scores were compared before sutgery, 1 and 3 months after surgery and at the final follow-up. The improvement of clinical symptoms and bone fusion rate were evaluated according to the improved rate of JOA score and X-rays data at the final follow-up.
All 18 patients were followed up from 14 to 34 months with an average of 24.3 months. All incisions got primary healing, and no nerve root injury, screw loose or rupture, threaded fusion cage sink or other complications were found. The postoperative VAS, lumbar JOA scores were improved significantly(<0.05). Neurologic function improved significantly in the final follow-up. The postoperative JOA improvement rate was excellent in 10 cases, good in 6 cases, and fair in 2 cases. Postoperative bone graft fusion rate was 100% at 3 to 6 months.
Unilateral screw fixation and lumbar interbody fusion under the Quadrant tunnel is an effective and safe method in treating prolapsed lumbar disc herniation for young patients, it has advantage of short operation time, small trauma and short hospitalization time. However, the indications should be well considered.
探讨象限通道下单侧螺钉固定联合腰椎椎间融合术治疗青年腰椎间盘突出症的临床疗效。
2015年1月至2017年1月,对18例青年腰椎间盘突出症患者采用象限通道下单侧椎弓根螺钉固定联合腰椎椎间融合术治疗。其中男10例,女8例,年龄20~28岁,平均22.5岁。比较手术前、手术后1个月、3个月及末次随访时的视觉模拟评分(VAS)、腰椎JOA评分。根据末次随访时JOA评分改善率及X线资料评估临床症状改善情况及骨融合率。
18例患者均获随访,随访时间14~34个月,平均24.3个月。所有切口均一期愈合,未发现神经根损伤、螺钉松动或断裂、椎间融合器下沉等并发症。术后VAS、腰椎JOA评分均显著改善(P<0.05)。末次随访时神经功能显著改善。术后JOA改善率优10例,良6例,可2例。术后3~6个月植骨融合率为100%。
象限通道下单侧螺钉固定联合腰椎椎间融合术治疗青年腰椎间盘突出症安全有效,具有手术时间短、创伤小、住院时间短等优点。但应严格掌握适应证。