摘要
目的观察斜外侧腰椎椎间融合术治疗单节段腰椎间盘退行性疾病的早期疗效。方法68例单节段腰椎间盘退行性疾病患者,均给予斜外侧腰椎椎间融合术治疗。分析患者的手术情况(手术时间、出血量),比较患者手术前后的恢复指标[视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分、日本骨科学会(JOA)评分、椎间隙高度、椎间孔高度]、生活质量评分、心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)评分]。结果68例患者均成功接受斜外侧腰椎椎间融合术治疗,平均手术时间(134.82±20.37)min,平均出血量(164.38±50.38)ml。68例患者手术前的VAS评分为(6.28±1.37)分,ODI评分为(67.38±5.62)分,JOA评分为(11.28±1.74)分,椎间隙高度为(9.34±1.82)mm,椎间孔高度为(16.83±2.71)mm;患者手术后的VAS评分为(3.01±0.63)分,ODI评分为(32.18±5.49)分,JOA评分为(21.37±1.95)分,椎间隙高度为(11.63±2.13)mm,椎间孔高度为(19.63±2.38)mm。手术后患者的VAS评分、ODI评分低于手术前,JOA评分、椎间隙高度、椎间孔高度均高于手术前,差异具有统计学意义(P<0.05)。68例患者手术前的躯体疼痛评分为(79.60±5.47)分,一般状况评分为(77.63±4.54)分,生理功能评分为(79.61±5.49)分,物质功能评分为(80.64±5.34)分,精力评分为(78.51±5.49)分,情感功能评分为(77.51±5.83)分,心理健康评分为(75.53±5.32)分,社会功能评分为(76.34±5.46)分;患者手术后的躯体疼痛评分为(86.63±5.62)分,一般状况评分为(83.48±5.39)分,生理功能评分为(84.36±5.62)分,物质功能评分为(86.29±5.27)分,精力评分为(84.39±5.82)分,情感功能评分为(84.46±5.43)分,心理健康评分为(85.74±5.48)分,社会功能评分为(83.36±5.29)分。手术后患者的躯体疼痛、一般状况、生理功能、物质功能、精力、情感功能、心理健康、社会功能评分均高于手术前,差异具有统计学意义(P<0.05)。68例患者手术前的SAS评分为(55.85±5.84)分、SDS评分为(58.62±5.23)分;患者手术后的SAS评分为(42.63±5.31)分、SDS评分为(44.39±5.76)分。手术后患者的SAS、SDS评分低于手术前,差异具有统计学意义(P<0.05)。结论单节段腰椎间盘退行性疾病患者行斜外侧腰椎椎间融合术治疗的早期疗效明确,能使患者疼痛减轻,腰椎功能恢复,改善负面情绪,提高生活质量,值得推荐使用。
Objective To observe the early curative effect of oblique lateral lumbar interbody fusion in the treatment of single-segment lumbar intervertebral disc degenerative disease.Methods 68 patients with single-segment lumbar intervertebral disc degenerative disease were treated with oblique lateral lumbar interbody fusion.The surgical situation(operative time,amount of blood loss)of patients was analyzed,and the recovery indexes[visual analogue scale(VAS)score,Oswestry Disability Index(ODI)score,Japanese Orthopaedic Society(JOA)score,intervertebral space height,intervertebral foramen height],quality of life score,and mental state[Self-Rating Anxiety Scale(SAS)score,Self-Rating Depression Scale(SDS)score]were compared before and after surgery.Results All 68 patients were successfully treated with oblique lateral lumbar interbody fusion,with mean operative time of(134.82±20.37)min and the mean blood loss of(164.38±50.38)ml.Before surgery,the patient's VAS score was(6.28±1.37)points,ODI score was(67.38±5.62)points,JOA score was(11.28±1.74)pints,the intervertebral space height was(9.34±1.82)mm,and the intervertebral foraminal height was(16.83±2.71)mm;after surgery,the patient's VAS score was(3.01±0.63)points,ODI score was(32.18±5.49)points,JOA score was(21.37±1.95)pints,the intervertebral space height was(11.63±2.13)mm,and the intervertebral foraminal height was(19.63±2.38)mm.After surgery,VAS score and ODI score of patients were lower than those before surgery,while JOA score,intervertebral space height and intervertebral foraminal height were higher than those before surgery.The differences were statistically significant(P<0.05).Before surgery,the patient's body pain score was(79.60±5.47)points,the general condition score was(77.63±4.54)points,the physiological function score was(79.61±5.49)points,the material function score was(80.64±5.34)points,and the energy score was(78.51±5.49)points,the emotional function score was(77.51±5.83)points,the mental health score was(75.53±5.32)points and the social function score was(76.34±5.46)points;after surgery,the patient's body pain score was(86.63±5.62)points,the general condition score was(83.48±5.39)points,the physiological function score was(84.36±5.62)points,the material function score was(86.29±5.27)points,and the energy score was(84.39±5.82)points,the emotional function score was(84.46±5.43)points,the mental health score was(85.74±5.48)points and the social function score was(83.36±5.29)points.After surgery,the scores of body pain,general condition,physiological function,material function,energy,emotional function,mental health and social function were all higher than those before surgery,and the differences were statistically(P<0.05).Before surgery,SAS score was(55.85±5.84)points and SDS score was(58.62±5.23)points;after surgery,SAS score was(42.63±5.31)points and SDS score was(44.39±5.76)points.The scores of SAS and SDS after surgery were lower than those before surgery,and the differences were statistically significant(P<0.05).Conclusion The early curative effect of oblique lateral lumbar interbody fusion for patients with single-segment lumbar intervertebral disc degenerative disease is definite,which can reduce pain,restore lumbar function,improve negative emotions and improve quality of life,and is worthy of recommendation.
作者
邓向爽
钱婧
陆家勇
孙胜
王兵
DENG Xiang-shuang;QIAN Jing;LU Jia-yong(Xuanwei Hospital of Traditional Chinese Medicine,Xuanwei 655400,China)
出处
《中国实用医药》
2023年第20期67-70,共4页
China Practical Medicine
关键词
单节段腰椎间盘退行性疾病
斜外侧腰椎椎间融合术治疗
早期疗效
Single-segment lumbar intervertebral disc degenerative disease
Oblique lateral lumbar interbody fusion
Early curative effect
作者简介
通讯作者:王兵。
