Single Or Double Side Segmental Pedicle Screws For The Treatment Of Lumbar Disc Disease Associsted With Degenerative Lumbar Instability Clinical Curative Effect Comparison

Objective:By comparing the unilateral and bilateral pedicle screw fixation combined with lateral lumbar vertebral plate removal expand vertebral canal decompression intervertebral cage bone graft fusion treatment with double segmental lumbar intervertebral disc protrusion the clinical effect of the treatment of degenerative lumbar instability, the superiority and feasibility evaluation of unilateral pedicle screw fixation.Methods:Analyzed retrospectively from June 2012 to February 2015 data of 36 patients admitted in our department complete with double segmental lumbar intervertebral disc protrusion in patients with degenerative lumbar spinal instability, including 18 cases with unilateral pedicle fixation group A, B group of 18 cases with bilateral pedicle fixation, all cases were performed with lateral vertebral lamina resection, spinal canal expansion stress, nerves release, and intervertebral cage fusion. Records of group A and group B operation time, intraoperative bleeding and postoperative flow and the length of hospital stay, and according to JOA (Japanese orthopedic association) scores and VAS (visual analog scale) scores overall evaluation study lumbar symptoms before and after operation and lower limb pain degree, and according to the obtained to estimate the postoperative period, line of lumbar lateral slice, during the follow-up period were performed at the time of the last follow-up lumbar+dual-energy CT scan, to observe the bone graft fusion, intervertebral bone graft fusion rate calculation, follow-up time is 7 to 32 months, an average of 19.5 months.Results:The results show that the group A in operation time, intraoperative blood loss, postoperative flow were less than group B, statistically significant difference (P< 0.05);In terms of length of hospital stay, differences between the two groups had no statistical significance (P> 0.05);In terms of complications, unilateral group found 1 case of loose nut, the others have not been found loose screw, fracture, cage slippage, shift or sinking, two groups was no statistical difference; In JOA score and VAS score, two groups of preoperative postoperative compare differences were statistically significant (P< 0.05).Conclusion:Unilateral and bilateral pedicle screw internal fixation with intervertebral fusion cage therapy with double segmental lumbar intervertebral disc protrusion degenerative lumbar instability in the near future curative effect and the stability of lumbar spine can get reliable, clinical symptoms improved obviously, intervertebral fusion rate are high, but the former in operation time, intraoperative blood loss, postoperative flow in and around the area and the operation is relatively simple, tissue injury is relatively small, can reduce postoperative complications related to.