Zhongguo gu shang = China journal of orthopaedics and traumatology · 2019
[Unilateral pedicle screw fixation and lumbar interbody fusion under the Quadrant tunnel for the treatment of prolapsed lumbar disc herniation in young patients].
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Zhang Li, Huang Ai-E
Аннотация
OBJECTIVE: To explore the clinical effect of unilateral screw fixation and lumbar interbody fusion under the Quadrant tunnel to treat prolapsed lumbar disc herniation in young patients.
METHODS: Between January 2015 and January 2017, 18 young patients with prolapsed lumbar disc herniation were treated with unilateral pedicle screw fixation and lumbar interbody fusion under Quadrant tunnel. Among them, there were 10 males and 8 females, aged from 20 to 28 years old with an average of 22.5 years. The VAS, lumbar JOA scores were compared before sutgery, 1 and 3 months after surgery and at the final follow-up. The improvement of clinical symptoms and bone fusion rate were evaluated according to the improved rate of JOA score and X-rays data at the final follow-up.
RESULTS: All 18 patients were followed up from 14 to 34 months with an average of 24.3 months. All incisions got primary healing, and no nerve root injury, screw loose or rupture, threaded fusion cage sink or other complications were found. The postoperative VAS, lumbar JOA scores were improved significantly(P<0.05). Neurologic function improved significantly in the final follow-up. The postoperative JOA improvement rate was excellent in 10 cases, good in 6 cases, and fair in 2 cases. Postoperative bone graft fusion rate was 100% at 3 to 6 months.
CONCLUSIONS: Unilateral screw fixation and lumbar interbody fusion under the Quadrant tunnel is an effective and safe method in treating prolapsed lumbar disc herniation for young patients, it has advantage of short operation time, small trauma and short hospitalization time. However, the indications should be well considered.
METHODS: Between January 2015 and January 2017, 18 young patients with prolapsed lumbar disc herniation were treated with unilateral pedicle screw fixation and lumbar interbody fusion under Quadrant tunnel. Among them, there were 10 males and 8 females, aged from 20 to 28 years old with an average of 22.5 years. The VAS, lumbar JOA scores were compared before sutgery, 1 and 3 months after surgery and at the final follow-up. The improvement of clinical symptoms and bone fusion rate were evaluated according to the improved rate of JOA score and X-rays data at the final follow-up.
RESULTS: All 18 patients were followed up from 14 to 34 months with an average of 24.3 months. All incisions got primary healing, and no nerve root injury, screw loose or rupture, threaded fusion cage sink or other complications were found. The postoperative VAS, lumbar JOA scores were improved significantly(P<0.05). Neurologic function improved significantly in the final follow-up. The postoperative JOA improvement rate was excellent in 10 cases, good in 6 cases, and fair in 2 cases. Postoperative bone graft fusion rate was 100% at 3 to 6 months.
CONCLUSIONS: Unilateral screw fixation and lumbar interbody fusion under the Quadrant tunnel is an effective and safe method in treating prolapsed lumbar disc herniation for young patients, it has advantage of short operation time, small trauma and short hospitalization time. However, the indications should be well considered.