Kết quả phẫu thuật bắt vít qua vỏ xương trong bệnh lý mất vững cột sống thắt lưng

To evaluate the results of transcortical bone screw surgery in lumbar spine instability. Subject and method: Retrospectively describe a series of 25 patients with single level degenerative lumbar spine instability who were treated by transcortical bone screw surgery combined with transforaminal lumbar interbody fusion at the Department of Neurosurgery, Cho-Ray Hospital on 01/06- 31/12/2018. Result: Mean surgical time 156.6 ± 29.4 minutes, incision length 4.86 ± 0.55cm, blood loss 190.6 ± 26.93ml, post-operative recovery time 3.67 days. Pain level according to VAS scale pre-operative, at hospital discharge, and 6 months post-operative, respectively: VAS back pain 6.04 ± 1.09; 4.36 ± 1.25; 2.8 ± 0.7 VAS root pain 5.92 ± 1.08, 4 ± 0.95, 2.76 ± 0.72. JOA score pre-operative, at discharge, 6 months post-operative were 10 ± 2.27, 12.88 ± 3, 18 ± 2.42, respectively. The very good and good recovery rate according to Hyrabayashi based on JOA was 76%. The degree of displacement correction (mm) pre-operative, at hospital discharge, and 6 months post-operative were 17.5 ± 2.2, 4.5 ± 1.7, 5.5 ± 0.78, respectively; degree of folding angle (0) 11.24 ± 2.81, 2.38 ± 0.52, 2.5 ± 0.66, interbody height (mm) 7.1 ± 3.56, 10.42 ± 1.58, 10.2 ± 1.66. The rate of bone healing reached 96%, 4% screw loose and the possibility of pseudarthrosis; the good overall surgical outcome was 52%. There were no postoperative complications. Conclusion: Transcortical bone screw surgery in degenerative lumbar spine instability is considered as a minimally invasive surgery with safety and effectiveness.