Bilateral pedicle screw fixation combined with interbody fusion for lumbar disc herniation: objective evaluation of CT imaging

doi:10.3969/j.issn.2095-4344.1944

Abstract

Abstract:

BACKGROUND: For patients with significant lumbar instability, surgical resection of the herniated intervertebral disc and enlargement of the narrowed nerve root canal are needed to relieve the compression of the lumbar nerve root. Simultaneously, internal fixation and bone graft fusion are needed to restore the stability of the spine when resecting the herniated intervertebral disc and enlarging the nerve root canal so as to relieve the symptoms of lumbar and leg pain caused by compression of lumbar nerve root caused by instability factors. Some studies believe that CT examination can accurately reflect whether the intervertebral disc protrusion occurs, and clearly show the shape, size and location of the intervertebral disc protrusion.

OBJECTIVE: CT imaging was used to evaluate clinical efficacy of bilateral pedicle screw fixation combined with interbody fusion for lumbar disc herniation.

METHODS: Data of 80 cases of lumbar disc herniation treated in Dalian Municipal Central Hospital from August 2015 to July 2017 were retrospectively analyzed. All patients received bilateral pedicle screw fixation combined with interbody fusion. This study was approved by the Ethics Committee of Dalian Central Hospital on June 30, 2018.

RESULTS AND CONCLUSION: (1) The operation was successfully performed in all patients. All patients were followed up. (2) The Visual Analogue Scale scores of low back and leg pain at 1, 3 months and final follow-up were significantly lower than those before operation (P < 0.05). (3) With the prolongation of time, the excellent and good rate of MacNab treatment in patients with lumbar disc herniation gradually increased (P < 0.05). (4) The ventral height of the intervertebral disc, the dorsal height of the intervertebral disc, the maximum height of the intervertebral foramen and the apex of the spinous process were significantly higher after treatment than that before treatment (P < 0.05). Imaging displayed that after treatment, the lumbar vertebral angle gradually recovered, and the intervertebral space height recovered. CT examination showed that the pedicle screw fixation was good, no breakage or loosening. Before and after treatment, there was a negative correlation of the ventral height of intervertebral disc, the dorsal height of intervertebral disc, the maximum height of intervertebral foramen, the distance between the apex of spinous process with Visual Analogue Scale score of low back pain and Visual Analogue Scale score of leg pain (P < 0.05). (5) Bilateral pedicle screw placement combined with vertebral fusion for the treatment of lumbar disc herniation has a significant clinical effect. CT imaging can be used not only to assess the condition but also to assess the ventral height of the intervertebral disc, the dorsal height of the intervertebral disc, the maximum height of the intervertebral foramen and the apex of the spinous process, the angle recovery of the lumbar spine, the location of the screw placement, and to identify whether the screw loosened or ruptured, and to evaluate the clinical efficacy.

Key words: lumbar disc herniation, bilateral pedicle screw fixation, interbody fusion, CT, ventral disc height, dorsal disc height, maximum intervertebral foramen height, apical distance of spinous process

CLC Number:

R459.9|R681.5+3|R445

Zheng Songwen, Meng Yi, Long Yuhan, Xu Zhe, Zhang Yonghua. Bilateral pedicle screw fixation combined with interbody fusion for lumbar disc herniation: objective evaluation of CT imaging[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(36): 5850-5855.

Figures/Tables 6

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