[1]周英杰.腰椎融合与非融合在腰椎间盘突出症手术中的合理选择[J].中医正骨,2014,26(10):3-6.
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腰椎融合与非融合在腰椎间盘突出症手术中的合理选择()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期数:
2014年10期
页码:
3-6
栏目:
专家述评
出版日期:
2014-10-30

文章信息/Info

作者:
周英杰
河南省洛阳正骨医院,河南 洛阳 471002
关键词:
腰椎 椎间盘移位 脊柱融合术 述评
摘要:
髓核摘除术是治疗腰椎间盘突出症的经典术式,疗效确切,但该术式10年以上远期疗效的优良率有所下降。由于对髓核摘除术后远期疗效下降的原因认识不足,加之一些临床医生对经济利益的过度追求,腰椎融合术在腰椎间盘突出症的手术治疗中出现滥用; 理念先进、操作简便且可保留脊柱节段运动功能、维持腰椎稳定性的腰椎非融合术亦受到临床医师的青睐,其应用也出现了扩大化现象。因此,应对腰椎间盘突出症手术中腰椎融合与非融合的问题进行深入讨论,以利于手术方式的合理选择。笔者认为:①髓核摘除术是治疗腰椎间盘突出症的经典术式,疗效确切,仍应是手术治疗腰椎间盘突出症的主流方法。②腰椎融合的目的是避免椎间盘的再突出和维持腰椎的稳定,对于单纯的腰椎间盘突出症患者,无须常规进行腰椎融合术,腰椎间盘突出症手术中行腰椎融合应严格把握手术指征。③和腰椎融合术相比,非融合技术在腰椎间盘突出症的手术治疗中具有一定优势,但应严格掌握适应证,慎重选择,避免盲目扩大手术适用范围,造成滥用。④微创技术的发展使传统的腰椎间盘突出症手术治疗方式发生了深刻变化,腰椎非融合术的概念和范畴进一步完善和扩大; 而腰椎融合术的应用逐渐减少,且进一步微创化、有限化、精确化和多样化。

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更新日期/Last Update: 2014-10-30