Frymoyer J W, Hanley E, Howe J, Kuhlmann D, Matteri R
Spine (Phila Pa 1976). 1978 Mar;3(1):1-6. doi: 10.1097/00007632-197803000-00001.
Seventy-nine percent of 312 patients who underwent lumbar disc surgery were evaluated at least 10 years postoperatively (mean equal to 13.7 years). Residual back and nerve root symptoms and functional impairment were equally as common among the 143 patients who underwent fusion as they were among the 64 patients who did not. Thirty percent of the patients whose spines were fused and 37.7% of those patients whose spines were not fused were considered long-term failures because of persistent symptoms or the need for reoperation. Thirty-seven percent of the fusion patients had persistent graft donor site symptoms. Examined patients showed a high percentage of residual neurologic defects. An unexplained positive Trendelenburg sign was present in 14.8% of the fusion patients and in 18.2% of the patients whose spines were not fused. Although retrospective studies often have problems of accuracy, this analysis confirms other observations that midline spinal fusion offers few benefits in the management of lumbar disc disease.
312例接受腰椎间盘手术的患者中，79%在术后至少10年（平均13.7年）接受了评估。在接受融合手术的143例患者和未接受融合手术的64例患者中，残留的背部和神经根症状以及功能障碍同样常见。因持续症状或需要再次手术，30%接受脊柱融合手术的患者和37.7%未接受脊柱融合手术的患者被视为长期治疗失败。37%的融合手术患者有持续的移植物供体部位症状。接受检查的患者中残留神经功能缺损的比例很高。14.8%的融合手术患者和18.2%未接受脊柱融合手术的患者存在无法解释的阳性特伦德伦伯格征。尽管回顾性研究往往存在准确性问题，但该分析证实了其他观察结果，即中线脊柱融合术在腰椎间盘疾病的治疗中益处不大。
