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腰椎融合内固定术对年轻患者腰椎间盘突出症的影响:一项回顾性研究。

Impact of Lumbar Fusion Internal Fixation on Lumbar Disc Herniation in Young Patients: A Retrospective Study.

机构信息

Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

出版信息

Med Sci Monit. 2024 Oct 28;30:e944570. doi: 10.12659/MSM.944570.

Abstract

BACKGROUND Lumbar fusion and internal fixation techniques have shown promise in treating lumbar disc herniation (LDH), yet the impact on lumbar function in young patients remains unclear. This study aimed to investigate the impact of lumbar fusion on lumbar function in young patients. MATERIAL AND METHODS A retrospective analysis was conducted on 330 patients diagnosed with LDH admitted to our hospital. Patients were divided into 2 groups: a control group (n=264) that underwent a minimally invasive procedure with a keyhole lens, and a research group (n=66) that underwent lumbar fusion internal fixation. Clinical features and therapeutic outcomes were assessed using Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) Lumbar Scores before surgery and 12 months postoperatively. Additionally, intervertebral space height, degree of vertebral spondylolisthesis (grades I, II, and III), incidence of adverse effects, and treatment efficacy were measured pre-and post-surgically. RESULTS No significant difference in ODI and JOA scores was found between the groups before surgery (P>0.05). Postoperatively, the research group had lower ODI scores, higher JOA scores, and lower intervertebral space heights compared to the control group (P=0.001). While grade 1 and 2 spondylolisthesis showed slight improvement (P>0.05), a significant difference was observed in grade III spondylolisthesis between the 2 groups (P=0.001). Additionally, the research group had a lower incidence of adverse effects (P=0.049) and higher treatment efficacy, although the difference was not statistically significant (P>0.05). CONCLUSIONS Lumbar fusion with internal fixation produced better postoperative outcomes and fewer adverse effects than minimally invasive procedures in young patients with lumbar disc herniation.

摘要

背景

腰椎融合和内固定技术已被证明对治疗腰椎间盘突出症(LDH)有一定疗效,但对年轻患者腰椎功能的影响尚不清楚。本研究旨在探讨腰椎融合对年轻患者腰椎功能的影响。

材料与方法

对我院收治的 330 例 LDH 患者进行回顾性分析。患者分为两组:对照组(n=264)采用微创小切口椎间盘镜下手术,研究组(n=66)采用腰椎融合内固定术。术前及术后 12 个月采用 Oswestry 功能障碍指数(ODI)和日本骨科协会(JOA)腰椎评分评估临床特征和治疗效果。此外,还在术前和术后测量了椎间隙高度、椎体滑脱程度(I、II、III 度)、不良反应发生率和治疗效果。

结果

两组患者术前 ODI 和 JOA 评分无显著差异(P>0.05)。术后研究组 ODI 评分较低,JOA 评分较高,椎间隙高度较低(P=0.001)。I 度和 II 度滑脱略有改善(P>0.05),但 III 度滑脱两组间差异有统计学意义(P=0.001)。此外,研究组不良反应发生率较低(P=0.049),治疗效果较高,但差异无统计学意义(P>0.05)。

结论

与微创小切口椎间盘镜下手术相比,腰椎融合内固定术治疗年轻腰椎间盘突出症患者术后效果更好,不良反应更少。

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