复发性腰椎间盘突出症(RLDH)融合与非融合治疗的疗效比较

M. A. Rehman, Saddam Pervaiz, Inamullah Asghar, M. Jahanzaib, Muhammad Akmal Hussain
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摘要

目的:比较融合术与非融合术治疗复发性腰椎间盘突出症的疗效。材料与方法:60例患者,年龄30 - 65岁,男女均可,在原发性腰椎间盘手术后至少6个月复发性椎间盘突出和神经根性疼痛。在接受标准翻修椎间盘切除术的RLDH(复发性腰椎间盘突出)患者中,硬膜外瘢痕组织被分离并部分切除(A组)。b组采用后外侧融合和经椎弓根螺钉固定。植入皮下抽吸引流管后,正常闭合。并对其效果进行了评价。日本骨科协会的核心被用来衡量术前和术后的临床投诉。结果:患者年龄以46 ~ 65岁为主,占58.33%。至初次手术平均复发时间为11.87个月。60%的患者报告?B组复发时间为12个月,a组为66.6%,两组均有26.67%的患者出现右侧病变。术前、术后平均JOA评分分别为22.34分、8.54分。平均回收率为59.32%。本研究报道非融合治疗与融合治疗的疗效分别为16.67%和63.33%。结论:复发性腰椎间盘突出症行融合治疗优于非融合治疗。
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Comparison of the Efficacy of Fusion with Non-Fusion Treatment for Recurrent Lumber Disc Herniation (RLDH)
Objective:  The study compared the efficacy of fusion with non-fusion treatment for recurrent lumbar disc herniation. Materials & Methods:  60 patients including 30 – 65 years of either gender, with recurrent disc herniation and radicular pain from at least six months after primary lumbar disc surgery. Epidural scar tissues were separated and partly resected in patients with RLDH (recurrent lumber disc herniation) undergoing standard revision discectomy (Group A). Posterolateral fusion and trans-pedicular screw fixation were used in Group B. Following the implantation of a subcutaneous suction drain, the closure was performed as usual. The effectiveness was evaluated. The Japanese Orthopedic Association's core was used to measure clinical complaints before and after surgery. Results:  Most of the patients (58.33%) were 46 – 65 years old. The mean recurrent time to primary surgery was 11.87 months. 60% of patients reported ? 12 months recurrent time in group B, and 66.6% in group A. Right side was noted in 26.67% of patients of both groups. The mean pre and post-operative JOA scores were 22.34 and 8.54, respectively. The mean recovery rate was 59.32%. This study reported the efficacy of non-fusion treatment versus fusion treatment as 16.67% and 63.33%, respectively. Conclusion:  We concluded that the fusion treatment is better than the non-fusion treatment for recurrent lumbar disc herniation.
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