Goel Atul, Patil Abhinandan, Shah Abhidha, Rai Survendra, Vutha Ravikiran, Ranjan Shashi, Bakale Nilesh, Vaja Tejas
Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Mumbai, Maharashtra, India.
Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.
J Craniovertebr Junction Spine. 2019 Oct-Dec;10(4):203-209. doi: 10.4103/jcvjs.JCVJS_113_19. Epub 2020 Jan 23.
An alternative novel form of surgical treatment for patients having prolapsed or bulging intervertebral disc, with or without associated osteophyte, related lumbar radiculopathy by "only fixation" or internal orthosis and aiming for segmental arthrodesis is presented.
During the period July 2014-October 2018, 44 patients presenting with symptoms of lumbar radiculopathy and diagnosed to have bulging, prolapsed or herniated lumbar intervertebral disc with or without associated osteophytes were treated by only spinal stabilization without resorting to any kind of bone, ligaments, osteophyte, or disc resection.
All patients had "immediate" postoperative relief from radicular symptoms. The Visual Analog Scale and the Oswestry Disability Index scores were used to assess the patient both before and after the surgical treatment. During the follow-up period that ranged from 10 to 60 months (average: 35 months), there was no recurrence of symptoms. Complete or significant resorption of the herniated disc was seen in 29 cases on follow-up radiological assessment.
Spinal segmental fixation without any manipulation of the herniated disc or osteophyte and without any kind of bone or soft-tissue decompression is a safe, effective, and rational method of treatment of lumbar radiculopathy related to intervertebral disc herniation.
提出一种新型手术治疗方式，用于治疗患有椎间盘脱垂或膨出、伴有或不伴有相关骨赘、且患有与之相关的腰椎神经根病的患者，通过“单纯固定”或内置矫形器实现节段性融合。
在2014年7月至2018年10月期间，44例表现出腰椎神经根病症状且被诊断为患有腰椎间盘膨出、脱垂或突出、伴有或不伴有相关骨赘的患者，仅接受了脊柱稳定手术，未进行任何形式的骨、韧带、骨赘或椎间盘切除。
所有患者术后神经根症状均“立即”缓解。采用视觉模拟评分法和Oswestry功能障碍指数评分对患者手术前后进行评估。在10至60个月（平均35个月）的随访期内，症状无复发。随访影像学评估显示，29例患者的突出椎间盘完全或显著吸收。
在不处理突出椎间盘或骨赘、不进行任何形式的骨或软组织减压的情况下进行脊柱节段固定，是治疗与椎间盘突出相关的腰椎神经根病的一种安全、有效且合理的方法。
