| Objective To compare the clinical ef ficacy of posterior unilateral and bilateral pedicle internal screw fixation com bined with interbody fusion cage for treatment of adjacent double segments of lumbar disc herniation.Methods Collect 40 cases of double festi val period of unilateral sym ptoms of patients with lum bar disc prol apse from December 2013 to Decem ber 2015 in Spine Surgery Affiliated Nanhua Hospital of Nanhua University. The data of 40 cases who have be enunderwent posterior unilateral or bilateral pedicle screw and inter body fusion c age for lum bar disc herniation were analyzed retro spectively.40 cases were divided into two groups A and B,A group of 20 patie nts with unilateral pedicle scre w fixation, B group of 20 patients with bilateral pedicle screw fixation,In all patients with the af fected side semi-lamin ectomy,vrtebral canal decompression,nerve root releas e and intervertebral fusion cag e implantation surgery.Record operative time, blood loss, postoperati ve drainage and hospital stay of A and B groups,Compared two groups of patients on operation time, intraoperative blood loss, postoperative flow and bone graft fusion rate, hospita lization days, im plants and t he incidence of complications. For preoperative and postoperative two groups,using Japanese orthopedic a ssociation score(JOA) and visual analog scale score(VAS), assessed the lower limb hemp pain and waist pain symptoms of the research object patientsbefore and after sur gery, analysed the data collected by statistical software, judged the postoperative improvement rate,and pe rformed lumbar lateral position during follow-up period,At the time of the last follow-up all performed Lumbar spine three-dim ensional CT,observed the bone graft fusion,and calculated the intervertebr al bone graft fusion rate.Follow-up time was 12 months.Results 1.After operation com paring the fusi on rate and the incidence of complications between the t wo groups, both groups achieved bony fusion;In terms of co mplications,here was 1 case of nut loosening in unilateral group, no loosening, breakage, cage slippage, displacement or subsidence of the screw rod system were found in the other cases, Com paring the two groups found P values > 0.05, no significant difference, no statistical significance; 2.There was statistically found P value in the two groups of hospital days <0.05, there was significant difference, with statistical significance; 3.Blood loss, postoperative drainage, built-cost supplies of unilateral pedicle screw group were significantly lower than the bilateral pedicl e screw group after operate, P values < 0.05, there was signifi cant difference,with statistical significance. 4.Comparing VAS and JOA of the tw o groups between after operation and before operation, there are signi ficant differences(P values < 0.05), with statistical significance.Conclusion 1.The short-term clinical effica cy of Unilateral and bilateral pedicle internal screw fixation combined with interbody fusion cage for treatment of adjacent double segments of lum bar disc herniation are satisfied, low back pain can be significantly improved, intervertebral fusion rates of two groups are high. 2.The unilateral nailing group in operation time, intraoperative blood loss, a built-in consumables cost and hosptal days, has advantage,and unilateral group procedure is relativ ely simple, damages of spinal anatomical structure and surrounding soft tissue are less during t he operation. 3.Unilateral 3 pedicle screw fixation combined with 2 interbody fusion cages in the clinical treatment of adjacent lumbar disc herniation in the near future is a safe and feasible, and more economical operation. |
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