单边椎弓根螺钉固定联合TLif治疗单节段腰椎间盘突出伴神经根病的临床应用体会

Clinical Application Experience of Unilateral Pedicle Bolt Fixation Combined with TLif in the Treatment of Single-Segment Lumbar Disc Herniation with Nerve Root Disease

摘要: 目的：探讨单边椎弓根螺钉固定联合经椎间孔椎体间融合术(TLif)治疗单节段腰椎间盘突出伴神经根病的临床疗效及应用体会。方法：回顾性分析我院采用单边椎弓根螺钉固定联合TLif治疗的50例单节段腰椎间盘突出伴神经根病患者的临床资料，观察手术时间、术中出血量、术后引流量、住院时间、术后并发症发生情况，采用VAS评分、JOA评分及Oswestry功能障碍指数(ODI)评估患者术前、术后的疼痛程度及腰椎功能恢复情况。结果：所有患者手术顺利，手术时间为(120.5 ± 25.6) min，术中出血量为(250.8 ± 50.2) ml，术后引流量为(150.6 ± 35.8) ml，住院时间为(10.2 ± 2.5) d。术后随访12~24个月，平均(18.5 ± 3.2)个月。术后患者腰腿疼痛症状明显较术前改善，VAS、JOA及ODI评分均较术前显著改善(P < 0.05)。术后未出现严重并发症。结论：单边椎弓根螺钉固定联合TLif治疗单节段腰椎间盘突出伴神经根病具有手术时间短、术中出血及术后引流量少、术后恢复较常规PLif手术快等优点，临床疗效明显，值得推广应用。

Abstract: Objective: To explore the clinical efficacy and application experience of unilateral pedicle bolt fixation combined with transforaminal interbody fusion (TLif) in the treatment of single-segment lumbar disc herniation with nerve radiculopathy. Methods: The clinical data of 50 patients with single-segment lumbar disc herniation with nerve radiculopathy treated with unilateral pedicle bolt fixation combined with TLif in our hospital were retrospectively analyzed. The operation time, intraoperative bleeding volume, postoperative drainage volume, hospitalization time, and postoperative complications were observed. The pain degree and lumbar function recovery of patients before and after surgery were evaluated by VAS score, JOA score, and Oswestry dysfunction index (ODI). Results: All patients had smooth surgeries, with an operation time of (120.5 ± 25.6) min, intraoperative bleeding of (250.8 ± 50.2) ml, postoperative drainage of (150.6 ± 35.8) ml, and hospitalization time of (10.2 ± 2.5) days. The postoperative follow-up was 12~24 months, with an average of (18.5 ± 3.2) months. The postoperative symptoms of waist and leg pain in patients were significantly improved compared with preoperative symptoms, and VAS, JOA, and ODI scores were significantly improved compared with preoperative scores (P < 0.05). No serious complications occurred after surgery. Conclusion: Unilateral pedicle bolt fixation combined with TLif in the treatment of single-segment lumbar disc herniation with radiculopathy has the advantages of short operation time, less intraoperative bleeding and postoperative drainage, faster postoperative recovery than conventional PLif surgery, and obvious clinical efficacy, worthy of promotion and application.