|
|
Outcomes of unilateral fixation on lumbar spinal stenosis |
LYU Zhouming ZENG Haobin TANG Shangde |
Second Department of Orthopedics, Zhuhai Hospital of Second Affiliated Hospital of Guangzhou University of Chinese Medicine Zhuhai Hospital of Guangdong Hospital of Triditional Chinese Medicine, Guangdong Province, Zhuhai 519000, China |
|
|
Abstract Objective To compare the clinical outcomes of unilateral versus bilateral pedicle screw fixation with transforaminal lumbar interbody fusion in lumbar stenosis. Methods From February 2015 to February 2016, in Zhuhai Hospital of Guangdong Hospital of Triditional Chinese Medicine, 60 lumbar spinal stenosis patients were selected, according to random number table, they were divided into two groups, treatment group (30 cases) were given unilateral versus bilateral pedicle screw fixation, and control group (30 cases) were given transforaminal lumbar interbody fusion. Clinical outcomes after surgery were evaluate by JOA and VAS, meanwhile, the lumbar spine lordosis angle (LL) and the pelvic incidence Angle (PI) were measured before and after surgery. Results JOA and VAS of two groups at same time were compared, the differences were not statistically significant (P > 0.05); JOA and VAS of two groups before surgery were compared with those after surgery, after surgery 3, 6, 12 mooths, the differences were statistically significant (P < 0.05). PI, LL of two groups at same time were compared, the differences were not statistically significant (P > 0.05); PI, LL of two groups before surgery were compared with those after surgery, after surgery 3, 6, 12 mooths, the differences were not statistically significant (P > 0.05). Conclusion Compared with ransforaminal lumbar interbody fusion, unilateral pedicle screw fixation has the same safe and effective outcome.
|
|
|
|
|
[1] Hukuda s,Mochizuki T,Ogata M,et al. Operations for cervical spondylotic myelopathy.A comparison of the results of anterior and posterior procedures [J]. J Bone Joint Surge Br,1985,67(4):609-615.
[2] Edwards N. A critical review of visual analogue scales in the measurement of clinical Phenomena [J]. Res Nurs Health,1991,14(1):81.
[3] 赵延胜,王文军.腰椎管狭窄症手术治疗进展. [J].中国现代手术学杂志,2009,13(1):70-74.
[4] 陈彦文,张汉军,方凯,等.单侧减压椎间融合内固定治疗老年退行性腰椎管狭窄症[J].颈腰痛杂志,2015,7(4):340-341.
[5] 张志敬,潘兵,刘海明.经椎间孔椎间融合术联合单侧椎弓根螺钉固定的生物力学研究[J].临床骨科杂志,2015, 10(5):623-626.
[6] 沈晓龙,张海龙,顾昕,等.微创经椎间孔椎间融合术联合单、双侧内固定治疗单间隙腰椎退变性疾病[J].中华骨科杂志,2014,34(7):749-755.
[7] Legaye J,Duval-BeaupereG.Hecquet J,et al. Pelvic incidence:a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves [J]. Eur Spine J,1998,7(2):99-103.
[8] Berthonnaud E,DimnetJ,Roussouly P,et al. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters [J]. J Spinal Disord Tech,2005, 18(1):40-47.
[9] 李亮,隋海涛,于学忠,等.轻度峡部裂性腰椎滑脱症融合前后脊柱-骨盆矢状位参数及临床疗效分析[J].中国修复重建外科杂志,2013.10(11):1338-1344.
[10] 费晗,李危石,孙卓然,等.退变性腰椎侧凸脊柱-骨盆矢状位影像学特点[J].中国脊柱脊髓杂志,2015.6(6):528-532.
[11] 郑召民,刘辉.脊柱-骨盆矢状面平衡及其在成人脊柱畸形治疗中的作用[J].中国脊柱脊髓杂志,2012,22(3):278-282.
[12] Lafage V,Schwab F,Skalli W,et al. Standing balance and sagittal plane spinal deformity:anlysis of spinopelvic and gravity line parameters [J]. Spine,2008,33(14):1572-1578.
[13] Lehman RA Jr,Vacearo AR,Bertagndi R,et al. Standard and minimally invasive approaches to the spine [J]. Orhop Clin North Am,2005,36(3):280-292.
[14] 范国明,陈其昕,龚遂良,等.影响正常人群骨盆入射角调节脊柱骨盆矢状面平衡的因素[J].中国临床解剖学杂志,2010,28(4):409-412.
[15] 邓必权,胡华,腾宇,等.经后路单侧椎板入路双侧减压椎间隙植骨融合内固定改良术治疗退变性腰椎管狭窄症[J].中国临床研究,2017,30(3):306-309.
[16] 李少辉,王平均,李斌,等.单边内固定联合椎间cage植骨融合治疗单侧相邻两节段腰椎间盘突出症[J].临床骨科杂志,2017(1):23-25.
[17] 唐福兴,邹崇祺,钟家云,等.椎间盘镜下椎间融合联合单侧椎弓根钉内固定治疗腰椎退变性疾病[J].中国骨与关节损伤杂志,2016,31(1):16-19.
[18] 宋晋刚,崔易坤,苗艳,等.经单侧减压融合、单边椎弓根螺钉内固定治疗腰椎退变性疾病[J].中国微创外科杂志,2016,16(5):441-444.
[19] 唐建华,赵丽丽,黄春明,等.微创通道辅助下减压椎间融合及单侧椎弓根钉内固定治疗腰椎间盘突出症[J].中国骨与关节损伤杂志,2016,31(7):748-749.
[20] 陈鉴权.L4/5单侧固定融合术后的邻近节段退变及临床疗效研究[D]. 广州:广州中医药大学,2016.
[21] 钟远鸣,付拴虎,李智斐,等.单双侧椎弓根螺钉内固定并后路腰椎体间融合修复腰椎退行性疾病的系统评价[J].中国组织工程研究,2016,20(9):1353-1360.
[22] 王化瑾,张健,盛伟斌.腰椎单双侧钉棒系统置入内固定与非内固定修复腰椎间盘突出症的比较[J].中国组织工程研究,2016,20(53):7939-7945. |
|
|
|