| ObjectiveResearch unilateral transforaminal interbody fusion in the clinical effects of unilateral pedicle screw fixation combined with joint bilateral pedicle fixation far lateral lumbar disc herniation, designed to confirm unilateral transforaminal interbody fusion fixation advantages of minimally invasive surgery combined with the clinical effect of unilateral pedicle. Materials and MethodsSelect April 2009-2012 October pole outside our hospital were 37 cases of patients with lumbar disc herniation, according to a random number table 37 patients were randomly divided into two groups, namely the unilateral group and the bilateral group, single side of the 20 cases: 11 cases of male patients, 9 cases of female patients, patients aged 42-64 years old.17 cases of bilateral group: 10 cases of male patients, female patients seven cases, patients aged 43-65 years were compared patients in the general information of gender, age, duration, and other aspects of the onset of segmental difference was not statistically significant(P> 0.05), comparable. Surgical methods:Unilateral group with unilateral transforaminal single cage fusion joint unilateral pedicle fixation; bilateral group with unilateral transforaminal single cage fusion joint bilateral pedicle screw fixation. Outcome measures:①were observed in operative time, blood loss, bed time and the cost of treatment before surgery; ②observed two groups of patients, VAS scores after 3 months, the VAS score relatively good rate and VAS score; ③were observed before and after surgery three months JOA score, the relatively good rate of JOA score improvement index and JOA score. Statistical methods:Institute of Medical Statistics data from application software SPSS17.0 statistics, which measured data with the mean ± standard deviation(± S) said t test; 2 test count data applications, such as P <0.05 indicates statistical significance. Results1.Time of surgery in patients with unilateral group(132.47 ± 19.24) min, bilateral group(184.57 ± 16.72) min, unilateral mean operative time shorter operative time difference with bilateral comparison group was statistically significant(t = 128.53, P <0.05); blood loss in patients with unilateral group(351.10 ± 38.50) ml, bilateral group(584.50 ± 97.40) ml, mean operative bleeding less unilateral group, with bilateral surgery group average bleeding was significantly(t = 117.57, P <0.05); unilateral group postoperative ambulation time was(43.75 ± 1.27) h, bilateral group(44.61 ± 0.74) h, the two groups mean preoperative after bed time difference was not statistically significant(t = 24.33, P> 0.05); hospitalization costs in patients with unilateral group(23.96 ± 2.4) thousand Yuan; surgery patients with bilateral group time was(38.58 ± 1.7) thousand, unilateral group of the average cost of hospitalization of patients was statistically significant(t = 23.57, P <0.05) and the bilateral group differences.2.VAS scores were compared in patients of two groups:unilateral group VAS score before surgery was(8.46 ± 0.83), after 3 months(2.01 ± 0.98); preoperative VAS score the bilateral group was(8.69 ± 0.32), after 3 months(2.34 ± 1.02), between the two groups, two groups of patients preoperative and postoperative VAS score 3 months VAS scores showed no significant difference(t1 = 1.73, t2 = 1.45, P> 0.05); within the group, the group with unilateral bilateral group of patients 3 months VAS scores were significantly lower than the preoperative, intraoperative there before comparing statistically significant differences in postoperative VAS score(t1 = 1.03, t2 = 1.93, P <0.05). Unilateral VAS score was 90% excellent,bilateral group was 94.12%, excellent rate of the two groups showed no significant difference( c2 = 5.27, P> 0.05).3.Comparison of patients JOA score of the two groups:Preoperative JOA score the unilateral group of patients(8.46 ± 0.83), after 3 months(22.01 ± 3.98); preoperative JOA score the bilateral group of patients(8.69 ± 0.32), after 3 months(22.34 ± 3.02)。Between the two groups, two groups of patients preoperative JOA score and postoperative JOA scores 3 months showed no significant difference(t1 = 14.35, t2 = 12.76, P> 0.05); within the group, the group with unilateral bilateral group of patients 3 months JOA scores were significantly lower than before surgery, before comparing surgery with significant postoperative JOA score was statistically significant difference(t1 = 12.12, t2 = 16.79, P <0.05). Comparison the excellent rate of JOA score of the two groups:Unilateral group JOA improvement was 95% in the index excellent bilateral group 94.12%, respectively, no significant difference between good rate(c2 = 13.26, P> 0.05). ConclusionUnilateral group with unilateral transforaminal single cage fusion joint unilateral pedicle fixation extreme lateral lumbar disc damage less posterior structure, easy to operate, reliable, recent clinical results than double the side of the pedicle screw fixation, forward VAS,JOA score reached satisfactory clinical results. |
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