改良tlif单侧钉棒系统固定治疗极外侧型腰椎间盘突出症临床疗效观察

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1、要目的：对极外侧型腰椎间盘突出症行改良经椎间孔腰椎融合术(transforaminallumbarinterbodyfusion,TLIF)结合单侧钉棒系统内固定治疗,观察其疗效结果。方法：自2009年10月?2011年10月的21例的极外侧型腰椎间盘突出症患者行改良TLIF结合单侧钉棒系统固定，对患者术前、术后的腰椎J0A评分和视觉模拟评分(VAS)进行对比和统计学分析。结果：患者随访3?18个月，腰椎J0A评分术前平均10.01±2.463分，高于末次随访时平均25.19±2.719分（t=-30.326,p

2、<0.01)；VAS评分术前平均8.76±0.984分，低于末次随访时平均1.82±0.947分（t=38.187’p<0.01)。结论:改良TLIF结合单侧钉棒系统固定治疗极外侧腰椎间盘突出症并发症少，疗效好，是一种行之有效的治疗方法。关键词极外侧型腰椎间盘突出症；改良经椎间孔腰椎融合术；单侧钉棒系统固定。Clinicalefficacyofmodifiedtransforaminallumbarinterbodyfusionwithsinglesidepedicle-rodsforthetreatmentof

3、farlaterallumbardischerniationSpeciality:OrthopedicsofTCMAuthor:JiangLeiTutor:Prof.XuZhanwangAbstractObjective:Toobervisetheclinicaleffectofmodifiedtransforaminallumbarinterbodyfusionwithsinglesidepedicle-rodsfixationforthetreatmentoffarlaterallumbardischerni

4、ation.Methods:FormOctober2009toOctober2011,weperformedmodifiedTLIFwithsinglesidepedicle-rodsfor21patientsdiagnosedasfarlaterallumbardischerniation.TheresultswerecomparedandanalyzedstatisticallybythescoreoflumbarJOAscoreandVisualAnalogueScore(VAS)betweenpre-op

5、erationandpost-operation.Result:Allthecaseswerefollowedupfor3?18months.ThelumbarscoreofJOAofpre-operationwas10.01土2.463,whichwaslowerthanthoseofpost-operation25.19±2.719(t=-30.326,p<0.01);TheVASofpre-operationwas8.76士0.984,whichwashigherthanthoseofpost-operat

6、ion1.82±0.947(t=38.187,p<0.01).Conclusion:TheoperationofmodifiedTLIFwithsinglesidepedicle-rodsfixationforthetreatmentoffarlaterallumbardischerniationisaneffectivemethodoftreatment,whichhaslesscomplicationsandsatisfactoryclinicalresult.Keywordsfarlateraldische

7、rmiation；modifiedtransforaminallumbarinterbodyfusion；singlesidepedicle-rodsfixation.目录弓I51■贼31.资料与方法31.1研究对象31.2临床资料41.3围手术期处理及手术方法51-4数据的获得71.5统计学分析92.9itit121.极外侧型腰椎间盘突出症的临床分型122.极外侧型腰椎间盘突出症的相关临床解剖123.极外侧型腰椎间盘突出症的病因134.极外侧型腰椎间盘突出症的症状和体征1

8、35.极外侧型腰椎间盘突出症的影像学检查136.极外侧型腰椎间盘突出症的临床特点147.经椎间孔入路椎间融合术的优势158.改良经椎间孔入路椎间融合术的适应症159.采用单侧钉棒系统固定的优势和缺陷1610?手术中的注意事项17^胃1819胃^22附录32致：ilt36改良TLIF单侧钉棒系统固定治疗极外侧型腰推间盘突出症临床疗效观察弓