Posterior pedicle screw fixation and interbody fusion in the treatment of recurrent lumbar disc herniation: an evaluation of vertebral stability

doi:10.3969/j.issn.2095-4344.2014.04.011

Abstract

Abstract:

BACKGROUND: Discectomy is an important therapy for lumbar disc herniation, but a small number of patients undergoing discectomy will relapse.

OBJECTIVE: To investigate the spinal stability following posterior pedicle screw fixation combined with interbody fusion cage for treatment of recurrent lumbar disc herniation.

METHODS: Twenty-six patients with recurrent lumbar disc herniation from January 2007 to December 2011 were enrolled and subjected to posterior pedicle screw fixation combined with interbody fusion cage. Pain relief and lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after posterior pedicle screw fixation combined with interbody fusion cage depending on literature search.

RESULTS AND CONCLUSION: All the 26 patients were followed up for 12-36 months. After treatment, all patients effectively alleviated the symptoms of low back pain, and lumbar interbody fusion was good, with a good rate of 96.2%. There was no pedicle screw loosening, broken, non-fusion phenomenon. Posterior decompression and interbody fusion cage combined with posterior pedicle screw fixation for recurrent lumbar disc herniation, characterized as fast symptom relief, strong fixation, exact interbody fusion exact, is an ideal treatment for recurrent lumbar disc herniation.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: lumbar vertebrae, internal fixators, bone nails, oint instability

CLC Number:

R318

Liu Feng-song, Wang Kai, Jing Cheng-wei, Zhang Liang, Liu Bin, Yang Ya-lin. Posterior pedicle screw fixation and interbody fusion in the treatment of recurrent lumbar disc herniation: an evaluation of vertebral stability [J]. Chinese Journal of Tissue Engineering Research, 2014, 18(4): 553-558.

Figures/Tables 2

References

[1] 殷明,熊文华,孟繁胜,等.腰椎间盘突出复发的相关因素与预防措施[J].当代医学,2012,18(17):19-20.

[2] 腾红材,贾连顺,肖建如,等.椎弓根螺钉内固定加单纯椎体间植骨融合治疗下腰椎不稳症[J].中国骨伤,2002,15(12):718-720.

[3] 万方数据库.万方医学网[DB/OL].2013-09-21.https://med.wanfangdata.com.cn

[4] Medline.Pubmed[DB/OL].2013-09-21.http://www.ncbi.nlm.nih.gov/pubmed/

[5] CNKI.中国知网[DB/OL].2013-09-21.https://www.cnki.net

[6] 张志,高梁斌,李健,等.后路椎体间植骨融合椎弓根钉内固定治疗复发性腰椎间突出症[J].中华生物医学工程杂志,2010,16(2): 167-170.

[7] 王平均,韩涛,倪凤民,等.腰椎间盘突出症再手术问题探讨[J].颈腰痛杂志,2009,30(1):47-49.

[8] 许耀军,史振江,史亚峰,等.双开窗椎弓根钉加椎间钛网植骨治疗复发性腰椎间盘突出伴失稳症56例[J].颈腰痛杂志,2008, 29(1): 54-56.

[9] 钱国祥,杨开舜,李绍波.复发性腰椎间盘突出症的手术治疗[J].现代医药卫生,2013,29(6):834-835.

[10] 张伟,陈德玉,杨立利,等.复发性腰椎间盘突出症两种术式的选择及疗效分析[J].中国矫形外科杂志,2013,21(9):883-886.

[11] 吕游,赵汉平,李佩佳,等.腰椎间盘突出复发的外科治疗探讨[J].中国矫形外科杂志,2009,17(11):822-824.

[12] Cinotti G, Gumina S, Giannicola G, et al.Contralateral recurrent lumbar disc herniation. Results of discectomy compared with those in primary herniation.Spine(Phila Pa 1976).1999;24(8):800-806.

[13] Barrick WT, Schofferman JA, Reynolds JB, et al.Anterior lumbar fusion improves discogenic pain at levels of prior posterolateral fusion.Spine (Phila Pa 1976). 2000;25(7): 853-857.

[14] 金今,赵振国,翁习牛,等.腰椎间盘突出症再手术治疗[J].中国医学科学院学报,2005,27(2):160-164.

[15] McGirt MJ, Ambrossi GL, Datoo G, et al.Recurrent disc herniation and long-term back pain after primary lumbar discectomy: review of outcomes reported for limited versus aggressive disc removal.Neurosurgery.2009;64(2):338-344;344-345.

[16] McGirt MJ, Eustacchio S, Varga P, et al.A prospective cohort study of close interval computed tomography and magnetic resonance imaging after primary lumbar discectomy: factors associated with recurrent disc herniation and disc height loss.Spine (Phila Pa 1976).2009;34(19):2044-2051.

[17] Watters WC 3rd, McGirt MJ.An evidence-based review of the literature on the consequences of conservative versus aggressive discectomy for the treatment of primary disc herniation with radiculopathy.Spine J. 2009;9(3):240-257.

[18] 许国华,贾连顺,李家顺,等.腰椎间盘突出症再手术临床分析[J].中国矫形外科杂志,2002,10(13):1342-1343.

[19] 李强,杨雍,赵易.腰椎间盘手术对腰椎节段矢状面稳定性影响的生物力学研究[J].首都科大学学报,1998,19(3):256-259.

[20] 申勇,杨大龙,张英泽,等.复发性腰椎间盘突出症的再手术治疗[J].中国脊柱脊髓杂志,2006,16(4):255-258.

[21] Brau SA, Delamarter RB, Kropf MA, et al.Access strategies for revision in anterior lumbar surgery.Spine (Phila Pa 1976). 2008;33(15):1662-1667.

[22] 袁维,徐建广.后路椎弓根螺钉固定加椎体间融合术治疗复发性腰椎间盘突出症[J].脊柱外科杂志,2008,6(4):221-223.

[23] Asano S, Kaneda K, Umehara S, et al.The mechanical properties of the human L4-5 functional spinal unit during cyclic loading. The structural effects of the posterior elements.Spine (Phila Pa 1976). 1992;17(11):1343-1352.

[24] 朱立国,王尚全,杨克新,等.腰椎经椎弓根螺钉系统内固定治疗腰椎间盘突出症[J].中国骨与关节损伤杂志,2006,21(2):94-96.

[25] Kat'uch V, Pataky F, Kat'uchová J, et al.Surgical management of the failed back surgery syndrome (FBSS) using posterior lumbar interbody fusion (PLIF) with posterior transpedicular stabilization.Rozhl Chir. 2010;89(7):450-458.