本文選題：單邊內(nèi)固定 + 腰椎間盤突出癥��； 參考：《承德醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討應(yīng)用Mast quadrant可擴(kuò)張通道系統(tǒng)行單邊椎弓根釘內(nèi)固定聯(lián)合椎間Cage植骨融合術(shù)治療腰椎間盤突出癥的臨床療效。方法:針對我科2014年1月到2016年1月住院,行腰椎間盤切除、椎間Cage植入融合、椎弓根釘內(nèi)固定手術(shù)的147例腰椎間盤突出癥病人進(jìn)行回顧性分析,其中應(yīng)用Mast quadrant可擴(kuò)張通道系統(tǒng)行單邊內(nèi)固定治療的患者59例,平均隨訪20.39±4.45個(gè)月;采用傳統(tǒng)開放TLIF行雙邊內(nèi)固定治療的患者88例,平均隨訪19.85±4.64個(gè)月。對比分析兩組病人的一般資料、術(shù)后住院天數(shù)、手術(shù)時(shí)間、術(shù)中出血量、住院治療費(fèi)用、手術(shù)前后的疼痛視覺模擬評分(VAS)和日本骨科協(xié)會(huì)評估治療(JOA)評分、植骨融合率、術(shù)后48h肌酸激酶(CK)升高值及并發(fā)癥的發(fā)生情況。結(jié)果:(1)與雙邊內(nèi)固定組比較,通道下單邊內(nèi)固定治療的患者的手術(shù)時(shí)間明顯縮短(P0.05),術(shù)中失血量明顯減少(P0.05),單邊組術(shù)后48h肌酸激酶(CK)升高值比雙邊組要低(P0.05)。(2)兩組之間的術(shù)后住院時(shí)間、住院治療費(fèi)用比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05);末次隨訪VAS、ODI、JOA評分以及植骨融合率比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:Mast quadrant可擴(kuò)張通道系統(tǒng)下行單邊內(nèi)固定并椎間融合治療單間隙腰椎間盤突出癥與傳統(tǒng)開放TLIF雙邊內(nèi)固定的療效相同,但通道下單邊內(nèi)固定具有手術(shù)創(chuàng)傷小、手術(shù)時(shí)間短、出血量少等優(yōu)點(diǎn),但手術(shù)適應(yīng)癥需嚴(yán)格控制。
[Abstract]:Objective: to investigate the clinical effect of unilateral pedicle screw fixation combined with intervertebral Cage fusion in the treatment of lumbar disc herniation with Mast quadrant extensible channel system. Methods: a retrospective analysis was performed on 147 patients with lumbar disc herniation who were hospitalized from January 2014 to January 2016, underwent lumbar discectomy, intervertebral Cage implantation and fusion, and pedicle screw fixation. 59 patients treated with unilateral internal fixation with Mast quadrant extensible channel system were followed up for an average of 20.39 鹵4.45 months, and 88 patients with conventional open TLIF for bilateral internal fixation were followed up for an average of 19.85 鹵4.64 months. The general data, postoperative hospitalization days, operative time, intraoperative bleeding volume, hospitalization cost, pain visual analogue score before and after operation (VAS) and Japanese Orthopedic Association (JOA) score, bone graft fusion rate, were compared and analyzed between the two groups. Creatine kinase (CK) increased at 48 h after operation and complications occurred. Results compared with bilateral internal fixation group, The operation time of patients treated with unilateral internal fixation under the channel was significantly shorter than that of the bilateral group, and the postoperative hospitalization time between the two groups was significantly lower than that in the bilateral group, and the blood loss during the operation was significantly reduced in the unilateral group, and the increase of creatine kinase (CK) in the unilateral group at 48 hours after operation was lower than that in the bilateral group. There was no significant difference in the cost of hospitalization (P 0.05), and there was no significant difference in the JOA score and bone graft fusion rate (P 0.05) during the last follow-up. Conclusion the effect of one-sided internal fixation and intervertebral fusion in the treatment of single-space lumbar disc herniation is the same as that of traditional open TLIF bilateral fixation, but the unilateral internal fixation under the channel has the advantages of minimal surgical trauma and short operative time. The amount of bleeding is low, but the indication of operation should be strictly controlled.
【學(xué)位授予單位】：承德醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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