王德明

[摘要] 目的 探讨后路扩大减压椎体间融合术治疗高位腰椎间盘突出症的疗效。 方法 选择2003年1月～2010年12月在我院采用后路椎板切除、减压、内固定和椎体间融合术治疗高位腰椎间盘突出症患者21例。观察术后治疗效果。 结果 本组病例21例，全部采用后路椎板切除减压、内固定和椎体间融合术治疗，所有入选病例均顺利完成手术，手术时间为60～120 min，平均（90.2±11.3）min，术中出血100～300 mL，平均（183.8±17.3）mL。随访8～25个月，平均随访17个月，本组患者术后优16例，良2例，可2例，差1例，优良率为86%。 结论 后路扩大减压椎体间融合术治疗高位腰椎间盘突出症疗效确切，其中后路椎板切除、减压及椎体间融合术可以重建脊椎的稳定性，手术效果良好，值得临床推广和应用。

[关键词] 高位腰椎间盘突出症；椎板切除；减压；内固定；椎体间融合

[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2018）23-0100-02

Therapeutic effect of posterior extended decompression and interbody fusion in the treatment of high lumbar disc herniation

WANG Deming

Department of Spinal Surgery，Xintai People's Hospital in Shandong Province，Xintai 271200，China

[Abstract] Objective To investigate the effect of posterior decompression interbody fusion in the treatment of high lumbar disc herniation. Methods 21 cases of high lumbar disc herniation from January 2003 to December 2010 were treated with posterior laminectomy， decompression， internal fixation and interbody fusion in our hospital. The postoperative treatment effect was observed. Results 21 cases in this group were all treated with posterior laminectomy， decompression， internal fixation and interbody fusion. All selected cases successfully completed surgery. The operation time was 60 minutes to 120 minutes， with an average of（90.2±11.3）minutes. The intraoperative blood loss was 100-300 mL， with an average of（183.8±17.3）mL. The patients were followed up from 8 to 25 months， with an average of 17 months. The patients in this group were excellent in 16 cases， good in 2 cases， fair in 2 cases， poor in 1 case， and the excellent and good rate was 86%. Conclusion Posterior extended decompression and interbody fusion is effective in the treatment of high lumbar disc herniation.Posterior laminectomy， decompression and interbody fusion can restore the stability of the spine. The surgical results are good and worthy of clinical promotion and application.

[Key words] High lumbar disc herniation； Laminectomy； Decompression； Internal fixation； Interbody fusion

腰椎間盘突出症是脊柱外科的常见病和多发病，常导致患者出现腰腿疼痛等症状。高位腰椎间盘突出症约占全部腰椎间盘突出症的1.00%～3.78%[1]，临床表现复杂。高位腰椎盘突出症外科治疗方法包括前路、后外侧和后路术；有开放传统方式，也有经皮内镜手术；有融合，有不融合。椎体间融合术治疗腰椎退行性疾病的疗效已经被肯定，后路扩大减压椎体间融合术近年来已经广泛应用于腰椎间突出症治疗中，并取得了较好的疗效，本研究旨在探讨后路扩大减压椎体间融合术治疗高位腰椎间盘突出症的疗效，我院自2003年1月～2010年12月，共收治21例高位腰椎间突出症病例，取得了较好的临床效果，现报道如下。……