两种椎弓根钉棒固定联合斜外侧椎间融合术治疗腰椎退变性疾病的疗效比较

doi:10.3969/j.issn.1006⁃5725.2021.02.004

实用医学杂志 ›› 2021, Vol. 37 ›› Issue (2): 144-148.doi: 10.3969/j.issn.1006⁃5725.2021.02.004

两种椎弓根钉棒固定联合斜外侧椎间融合术治疗腰椎退变性疾病的疗效比较

王志强，梁思敏，蔡则成，康毅，郭伟，戈朝晖

1 宁夏医科大学研究生学院（银川 750004）；2 宁夏医科大学总医院骨科（银川 750004）

出版日期:2021-01-25 发布日期:2021-01-25
通讯作者: 戈朝晖 E⁃mail：myovid@126.com
基金资助:
2020宁夏重点研发计划项目（编号：2020BEG03034）；宁夏自然科学基金项目（编号：2018AAC03263）

Comparison of clinical effects of two kinds of pedicle screw fixation combined with oblique lumbar inter⁃ body fusion in the treatment of lumbar degenerative diseases

WANG Zhiqiang，LIANG Simin△ ，CAI Zech⁃ eng，KANG Yi，GUO Wei，GE Zhaohui.

Graduate School of Ningxia Medical University，Yinchuan 750004，Chi⁃ na；△Department of Orthopaedics，General Hospital of Ningxia Medical University，Yinchuan 750004，China

Online:2021-01-25 Published:2021-01-25
Contact: GE Zhaohui E⁃mail：myovid@126.com

摘要/Abstract

摘要：

目的比较单侧与双侧椎弓根钉棒固定联合斜外侧椎间融合术治疗腰椎退变性疾病的疗效。方法回顾性分析2017年7月至2019年11月在我院行斜外侧椎间融合术联合椎弓根钉棒固定治疗腰椎退变性疾病患者86例，其中OLIF联合经Wiltse入路单侧椎弓根钉棒固定53例，OLIF联合经后正中入路双侧椎弓根钉棒固定33例，通过腰痛VAS评分、Oswestry功能障碍指数评估两组患者手术后的临床疗效、通过椎旁肌肌电图评估椎旁肌受损情况、通过影像学测量不同时间段椎间隙高度，并评估椎体间融合情况以及分析相关并发症。结果术后不同时间段单侧椎弓根钉棒固定组患者腰疼VAS 评分、ODI指数均优于双侧椎弓根钉棒固定组（P<0.05）；手术时间、术中出血量、住院费用和椎旁肌去神经化发生率均少于双侧椎弓根钉棒固定组，差异有统计学意义（P<0.05），平均住院日、并发症发生率、融合率等两组差异无统计学意义（P>0.05）。结论经 Wiltse入路单侧椎弓根钉棒固定联合斜外侧椎间融合术治疗腰椎退变性疾病临床疗效满意，与经后正中入路双侧椎弓根螺钉棒固定相比，单侧椎弓根钉棒辅助固定创伤更小、椎旁肌失神经化发生率更低。

关键词:

脊柱融合术, 退行性疾病, 单侧椎弓根钉棒

Abstract:

Objective To compare the efficacy of unilateral and bilateral pedicle screw fixation combined with OLIF in the treatment of lumbar degenerative diseases. Methods A total of 86 patients with lumbar degenerative diseases were treated with OLIF combined with pedicle screw fixation in our Hospital from July 2017 to November 2019. 53 cases were treated with OLIF combined with unilateral pedicle screw fixation，and 33 patients in bilateral pedicle screw fixation group. The clinical effects of the two groups were evaluated by low back pain VAS and ODI. The damage of paraspinal muscles was evaluated by paraspinal electromyography，and the height of intervertebral space was measured by imaging. Interbody fusion was evaluated and related complications were analyzed. Results The VAS score and ODI index of low back pain in the UPS group were lower than those in the BPS group at different time after operation. The operation time，intraoperative blood loss，hospitalization cost and the incidence of paraspinal muscle denervation in the UPS group were significantly lower than those in the BPS group（P < 0.05）. There was no significant difference in the average hospital stay，incidence of complications and fusion rate between the two groups（P > 0.05）. Conclusion Unilateral pedicle screw fixation combined with OLIF via Wiltse approach has a satisfactory clinical effect in the treatment of lumbar degenerative diseases. It has less trauma and lower incidence of paraspinal muscle denervation.

Key words:

spinal fusion, lumbar degenerative diseases, unilateral pedicle screw

王志强梁思敏蔡则成康毅郭伟戈朝晖.

两种椎弓根钉棒固定联合斜外侧椎间融合术治疗腰椎退变性疾病的疗效比较

[J]. 实用医学杂志, 2021, 37(2): 144-148.

WANG Zhiqiang, LIANG Simin△ , CAI Zech⁃ eng, KANG Yi, GUO Wei, GE Zhaohui.

Comparison of clinical effects of two kinds of pedicle screw fixation combined with oblique lumbar inter⁃ body fusion in the treatment of lumbar degenerative diseases [J]. The Journal of Practical Medicine, 2021, 37(2): 144-148.

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两种椎弓根钉棒固定联合斜外侧椎间融合术治疗腰椎退变性疾病的疗效比较

Comparison of clinical effects of two kinds of pedicle screw fixation combined with oblique lumbar inter⁃ body fusion in the treatment of lumbar degenerative diseases

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