Abstract：Objective: To analyze the therapeutic effect of modified posterior lumbar interbody fusion on patients with lumbar disc herniation and analyze the multivariate logistic regression of complications.Methods: The clinical data of 243 patients with lumbar disc herniation treated in our hospital from May 2018 to May 2019 were analyzed. Random number table method was used for simple random grouping. The patients treated with posterior lumbar interbody fusion were selected as the control group (n= 121),and the patients treated with modified posterior lumbar interbody fusion were selected as the study group (n=122). The clinical efficacy,complications,functional recovery and pain in different periods were compared between the two groups. Logistic regression analysis was used to determine the risk factors of postoperative complications after modified posterior lumbar interbody fusion in patients with lumbar disc herniation. Results: The excellent and good rate of patients in the study group was significantly higher than that in the control group (97.80% vs 78.51%) (P<0.05). The VAS score and ODI score of the two groups one month,three months and half a year after surgery gradually decreased,and the decreasing of the study group was more significant (P<0.05). There was no significant difference in the incidence of complications such as transient neurological deficit,dural tear,nerve root injury,infection,etc. between the two groups (P>0.05). According to the analysis of unconditional multi-factor Logistic regression model,the risk factors affecting postoperative complications of patients with lumbar disc herniation after modified posterior lumbar interbody fusion are:BMI≥25kg / m2,long operation time,heavy bleeding,large postoperative drainage volume and long time in bed (P<0.05). Conclusion: Modified posterior lumbar interbody fusion in the treatment of patients with lumbar disc herniation has good clinical efficacy and significant effect on postoperative pain and functional recovery. At the same time,controlling the patient's BMI value before operation,reducing the operation time and blood loss during operation,reducing the drainage volume after operation and shortening the time in bed can effectively reduce the occurrence of postoperative complications.
杜卓姝, 倪冬贝, 张仑. 腰椎间盘突出症患者经改良后路腰椎椎体间融合术治疗疗效及并发症的影响因素[J]. 河北医学, 2021, 27(4): 556-562.
DU Zhuoshu, NI Dongbei, ZHANG Lun. The Effect of Modified Posterior Lumbar Interbody Fusion on Patients with Lumbar Disc Herniation and Influencing Factors of Complications. HeBei Med, 2021, 27(4): 556-562.
[1] 侯辉宝,张力人,李国强,等.经皮椎间孔镜下髓核摘除术与小切口椎板间开窗髓核摘除术治疗腰椎间盘突出症患者的对比研究[J].河北医学,2019,25(5):828~834. [2] 徐红辉,宋建东,刘波,等.改良PLIF治疗复发性腰椎间盘突出症的疗效及影响并发症发生的危险因素[J].中国骨与关节杂志,2019,17(10):756~761. [3] 钟炯彪,曾琦芳,许胤,等.改良Thessys椎间孔镜技术治疗腰椎间盘突出症的疗效及影响因素分析[J].中国临床医生杂志,2019,47(11):153~154. [4] 段亮,范亚一,徐洪海,等.症状型腰椎间盘突出症应用腰椎过伸过屈位MRI的诊断价值及手术治疗效果[J].中华实用诊断与治疗杂志,2019,32(9):144~146. [5] 徐世尧,宋国泉,贺冬云,等.PELD与MED手术治疗腰椎间盘突出症的疗效比较[J].中国骨与关节损伤杂志,2019,33(11):412~413. [6] 何玉宝,徐林,任龙喜,等.糖尿病对腰椎间盘突出症经皮椎间孔镜下椎间盘切除术后疗效的影响[J].国际外科学杂志,2019,46(3):176~181. [7] 古伟文,李荧婷,吴少鹏.脊柱侧后路经皮椎间孔内镜联合补肾活血方治疗腰椎间盘突出症的疗效观察[J].中国中医骨伤科杂志,2019,26(12):157~158. [8] 戎国栋,赵鸿,吴蕾,等.全自动核酸提取检测仪选择和评价方案的建立和应用[J].分子诊断与治疗杂志,2019,31(3):233~237. [9] 伦新新,胡志嵩,陈园坤,等.生物素修饰蛋白真核表达载体的构建与应用[J].医学分子生物学杂志,2019,41(1):1~6. [10] Lai O J,Hu Y,Yuan Z S,et al.Clinical and radiological results of thoracic and lumbar fracture and dislocation treated with posterior transforaminal decompression and interbody fusion[J].China Journal of Orthopaedics&Traumatology,2019,32(3):207~211. [11] 田建平,张凯,赵杰.经椎间孔腰椎椎体间融合联合单侧椎弓根钉棒固定术后融合器沉降及其对临床疗效的影响[J].中国脊柱脊髓杂志,2019,28(4):147~149. [12] Wang W,Sun X,Zhang T,et al. Topping-off technology versus posterior lumbar interbody fusion in the treatment of lumbar disc herniation:a meta-analysis[J]. BioMed Research International,2020,2020(22):1~10.
2021, Vol. 27 
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