Unilateral pedicle screws on the side of the transarticular screw fixation combined with interbody fusion and traditional operation in the treatment of lumbar tube stenosis of the efficacy and safety of comparison
10.3760/cma.j.issn.1008-6315.2017.05.014
- VernacularTitle:单侧椎弓根螺钉对侧经关节突螺钉固定联合椎体间融合术与传统手术治疗腰椎管狭窄症效果和安全性比较
- Author:
Kaiwen TIAN
- Keywords:
Pedicle screw;
Interbody fusion;
Lumbar canal stenosis;
Facet screw
- From:
Clinical Medicine of China
2017;33(5):441-444
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the contralateral transarticular screw fixation combined with interbody fusion and traditional operation in the treatment of lumbar tube stenosis of the efficacy and safety of unilateral pedicle screw.Methods A retrospective analysis was made in General Hospital of Lanzhou Petrochemical Company from February 2012 to April 2015.Forty cases of lumbar spinal stenosis patients were analyzed respectively,using unilateral pedicle screws on the side of transarticular screw fixation(observation group,20 cases) and bilateral pedicle screw fixation (control group,20 cases) and interbody fusion for the treatment.Between the two groups in the amount of bleeding,operation time,incision length,postoperative drainage were compared.Regular follow-up after operation,the fusion effect was observed,the JOA score was used to evaluate spinal function and observe adverse reaction incidence.Results Intraoperative bleeding volume,operation time and postoperative drainage in the observation group were (321.60±12.35) ml,(101.18±4.11) min,(212.14±18.78) ml,lower than that in control group((377.24±18.11) ml,(134.49±5.25) min,(256.27±15.19) ml,t=2.80,4.11,-3.88,P<0.05).While the incision length was (6.46 ±0.14) cm,(6.49±0.13) cm,respectively and there was no significant difference between the two groups(t=0.10,P>0.05).The fusion rate and JOA score in the observation group after 3 months of observation group was (100±0)% and (87.5±2.4) points,there was no statistically significant difference compared with the control group((100±0)% and (86.3±2.2) points,t=0,0.20,P>0.05).The fusion rate and JOA score in the observation group after 1 year was (100±0)% and (91.9±1.7) points,there was no statistically significant difference compared with the control group((100±0)% and (92.1±1.5) points,t=0,0.35,P>0.05).The height of intervertebral space in the last follow-up group in the observation group was (8.25±0.13) mm,higher than that of the control group((6.97±0.16) mm,t=3.90,P<0.001).In adverse reactions,the observation group did not appear to be related to complications,while 2 cases in the control group dural leakage,3 cases of nerve injury,rate was 25%(P=0.03).Conclusion Unilateral pedicle screws on the side of the transarticular screw fixation combined with interbody fusion for the treatment of lumbar tube stenosis surgical trauma,postoperative recovery,spinal stability is good in the near future,it is worth clinical promotion.
