摘要目的 探讨后路椎体间植骨融合椎弓根钉内固定术治疗复发性腰椎间盘突出症的临床疗效.方法 回顾性分析本院2002年4月至2007年10月19例复发性腰椎间盘突出症患者的临床资料,包括临床表现、初次手术方式、再次手术方式、术后效果及其预后.结果 所有复发性腰椎间盘突出症患者经后路椎体间植骨融合椎弓根钉内固定术治疗,术后优良比例为84.2%(16/19),有效比例为94.7%(18/19);下腰痛JOA评分术前(10.0±1.9)分,术后(22.5±0.9)分(P<0.05).随访发现除1例患者外,其余患者腰背部疼痛明显缓解,植骨融合情况良好,未出现脊柱不稳定.结论 后路椎体间植骨融合椎弓根钉内固定术可明显缓解复发性腰椎间盘突出症患者下腰痛症状,促进相邻椎体达到骨性愈合,恢复脊柱稳定.

abstractsObjective To investigate the clinical efficacy of posterior intervertebral bone graft fusion and pedicle screw internal fixation for recurrent lumbar intervertebral disc protrusion (IDP).Methods A retrospective study was conducted in data of 19 cases with recurrent lumbar IDP in our hospital between April 2002 and October 2007,including clinical manifestations,primary and secondary approaches of surgery,post-surgical outcome and prognosis. Results Posterior intervertebral bone graft fusion and pedicle screw internal fixation for recurrent lumbar IDP yielded excellent outcome in 84. 2% (16/19) of the patients,with a total response rate of 94.7% (18/19). The JOA score of lower back pain was 22.5±0.9 after procedure vs 10.0± 1.9 before treatment (P<0.05). Follow-up revealed that all but one patient experienced significant improvement in lower back pain and good intervertebral bone graft fusion without instable spinal column. Conclusion Posterior intervertebral bone graft fusion and pedicle screw internal fixation is effective to relieve lower back pain,promote bony union of adjacent vertebrae and resume spinal stabilization in patients with recurrent lumbar IDP.