显微内窥镜下腰椎间盘髓核摘除术后中远期疗效分析  

An analysis of medium and long term curative effects in treatment of lumbar disc herniation with microendoscopic discectomy

作　　者：岳兵[1] 蒋国强[1] 欧阳甲[1] 王如林[1] 卢斌[1] 罗科锋[1] 韩成钢[1] 曹杰波[1] 

机构地区：[1]宁波大学医学院附属医院,浙江宁波315020

出　　处：《现代实用医学》2008年第9期691-693,共3页Modern Practical Medicine

摘　　要：目的探讨显微内窥镜下腰椎间盘髓核摘除术(MED)的中远期疗效。方法对170例单节段腰椎间盘突出症患者分别行MED手术(MED组,90例)和常规后路手术(常规组,80例)治疗,对两组的手术时间、术中失血量及手术疗效进行比较,并比较两组来院复查患者术后与术前的腰椎间隙高度率(Mochida’s法)及脊柱稳定性。对两组患者残留下腰痛情况进行对比分析。结果MED组及常规组手术时间与术中失血量比较差异均有显著性(P<0.01),MED组残留下腰痛发生率低于常规组(P<0.05),Nakai评分优良率差异无显著性(P>0.05),术前JOA评分及术后恢复率差异均无显著性(P>0.05),但中远期JOA评分MED组高于常规组(P<0.05)。两组复查病例术后与术前的腰椎间隙高度率差异无显著性(P>0.05),发生手术节段腰椎不稳两组差异无显著性(P>0.05)。结论单节段腰椎间盘突出症行MED手术在严格掌握适应证及熟练的手术操作技巧基础上,可取得满意的中远期疗效。Objective To investigate the medium and long term curative effects in treatment of single-level lumbar disc herniation （LDH） with microendoscopic discectomy （MED）. Methods 170 patients were treated by the methods of MED（90 patients） or traditional discectomy （80 patients） .The operating time, blood loss and curative effects were compared respectively.The post- and preoperative height rates of intervertebral space （Mochida＇ s method） and the stability of spine were compared in the patients who came hospital for rechecking.Low back pain was compared between the two groups. Results The operating time and blood loss in MED group were less than those in traditional group significantly （P〈0.01）. The incidence rate of low back pain in MED group was lower than that in traditional group（P〈0.05）.No significant difference was seen in the rates of excellent-good outcome from Nakai＇s scoring system,or the preoperative JOA scores and the postoperative recovery rates from JOA scoring system（P〉0.05）, but the postoperative JOA score in MED group was higher than that in traditional group significantly （P〈0.05）. No significant difference was seen in post- and preoperative height rates of intervertebral space and the stability of spine significantly （P〉0.05）. Conclusions On basis of mastering the indications and practised surgical skills strictly, MED in treating with single-level lumbar disc herniation can get a satisfactory medium and long term curative effect.

关 键 词：腰椎间盘移位 椎间盘切除术 内窥镜检查 疗效 

分 类 号：R681.5[医药卫生—骨科学]