单侧椎弓根螺钉对侧关节突螺钉固定黄韧带保留治疗腰椎退变性疾病的临床疗效

目的：观察单侧椎弓根螺钉对侧关节突螺钉固定黄韧带保留治疗腰椎退变性疾病的临床疗效。方法对45例退变性腰椎间盘突出、椎管狭窄、下腰椎失稳患者采用单侧椎弓根螺钉对侧关节突螺钉固定黄韧带保留手术治疗，采用日本骨科协会（ Japanese Orthopedic Association，JOA）评分对手术疗效进行评估。通过影像学评价椎板关节突螺钉位置，并观察术后和末次随访时内固定位置、融合情况以及病变节段椎间隙高度情况。结果本组患者术后症状明显缓解，JOA评分较术前有显著改善，影像评价椎板关节突螺钉位置良好，未发现内固定松动和断裂，椎间融合率100%。结论单侧椎弓根螺钉对侧关节突螺钉固定黄韧带保留治疗腰椎退变性疾病手术创伤小，术后融合率高，有效预防了手术后神经粘连，疗效肯定。

CLINICAL EFFECT OF UNILATERAL LUMBAR PEDICLE SCREW AND TRANSLAMINA FACET SCREW FIXATION WITH LIGAMENTUM FLAVUM PRESERVATION IN LUMBAR DEGENERATION DISEASES

OcjectiVe To eXplore the clinical effect of unilateral lumbar pedicle screw and translamina facet screw fiXation with ligamentum flavum preservation in treatment of lumbar degeneration disease. Methods Forty-five patients who suffered from lumbar degeneration diseases were trated with unilateral lumbar pedicle screw combined and translamina facet screw fiXation with ligamentum flavum preservation. Japanese Orthopedic Association（ JOA）score was adopted to evaluate postoperative effect. Translamina facet screw position was eXamined with radiographic imaging,and looseness and shift of internal fiXation after surgery were also evaluated. The intervertebral space height of preoperative and postoperative check was compared. Results The group of patients improved obviously in postoperative neurological function with higher JOA scores. The position of translamina facet screw was good. There were no looseness and shift,the intervertebral fusion rate was 100%. Conclusion The unilateral lumbar pedicle screw and translamina facet screw fiXation with ligamentum flavum preservation has advantages of minimall invasion,high fusion rate. This surgery method efficiently prevents neural adhesion,and shows good effects.