Curative Effect Analysis Of Pedicle Screw Combined With Posterior Lumbar Interbody Fusionfor The Treatment Of Single-segment Lumbarintervertebraldischerniation

Objective To evaluate the clinical effect of the PLIF combined with pedicle screw fixation for the surgical treatment of single-segment lumbar intervertebral disc herniation.Methods The study included71patients diagnosed with single-segment lumbar intervertebral disc herniation(L4/L5、L5/S1) who underwent surgical treatment in the spine surgery of our hospital from March2012to December2012, including45males and26famales ranging from35to68years,the average age were51.2years.The patients had this disease for about6months to30months with a mean of18months. The total included39patients in L4/L5and32patients in L5/S1. All patients underwent the posterior lumbar interbody fusion combined with pedicle screw fixation after positive preoperative preparation.we took lumbar X-ray graphs and let the patient fill in the JOA questionnaires after3months,6months and12months respectively,and through the result,we could evaluate the clinical efficacy by bone fusion, disc height, low back pain the Japanese Orthopaedic Association score (JOA score) and improvement rate of JOA.Results The Study of71cases of patients were followed up for6to12months, with an average of10months. All patients did not occur wound infection or nerve root injury. Cerebrospinal fluid leak happened in5patients because of intraoperative dural adhesions surrounding tissue, we used non-invasive surgery suture to repair it, unpluged wound drainage after72hours, and bandaged for one week, combined with the trendelenburg position, the wounds healed well.11patients occurred lowe limb pain or numbness, after disabling the hormone drugs and dehydration for2-3days,when given symptomatic treatment,their symptoms were relieved.There were neither broken nails or rods nor cages displacement. Patients with low back pain, leg pain, numbness symptoms were significantly relieved3months later, all patients returned to normal lives after6months. By the fusion of Lenke standard,Grade A,45cases, accounting for63.4%. Grade B,22cases, accounting for31.0%. Grade C,4patients, accounting for5.6%; The height of the intervertebral space measured3months after surgery were significantly improved, the difference was statistically significant (P<0.05); The intervertebral space height changed12months later compared with the3months’, but the difference was not statistically significant significance (P>0.05); The clinical symptoms of all patients were significantly reduced, and their quality of life improved significantly, JOA score was significantly higher than those before surgery, the difference was statistically significant(P <0.05). The JOA improvement rate was as follows,excellent31, good34, medium6after3months.And excellent in49cases, good in20cases, medium in2cases12months later.Conclusion The posterior lumbar interbody fusion combined with pedicle screw fixation is an effective surgical method for the treatment of single-segment lumbar intervertebral disc herniation.