髓核成形术与经皮腰椎间盘摘除术治疗腰椎间盘突出症的对比研究  

Comparative study of nucleoplasty and percutaneous discectomy for lumbar disc herniation

作　　者：谭加群 李建赤 谢伟健[1] 梁江声 徐家宝[1] 

机构地区：[1]广东省佛山市顺德桂洲医院骨科,佛山市528305

出　　处：《微创医学》2010年第2期100-102,共3页Journal of Minimally Invasive Medicine

基　　金：广东省佛山市科技局攻关项目(200808118)

摘　　要：目的比较低温等离子射频消融髓核成形术与经皮椎间盘摘除术治疗包容性腰椎间盘突出症的疗效。方法60例经体格检查、X线、CT和MRI检查确诊的包容性腰椎间盘突出症患者随机分为两组，髓核成形术治疗组和经皮椎间盘摘除术治疗组各30例。按Macnab评定标准和VAS评分对其疗效进行评定分析。结果60例患者均获得随访，时间6～26个月，髓核成形术治疗组和经皮摘除术组总体治疗优良率为83．33％和80．00％，差异无统计学意义（P〉0．05）；两组平均手术时间分别为（24．00±2．15）min和（47．00±3．65）min，平均住院时间分别为（3．20±0．72）d和（6．90±1．15）d，差异有统计学意义（P〈0．05）。结论髓核成形术和经皮摘除术治疗包容性腠椎间盘突出症优良率相近，髓核成形术组手术和住院时间短，损伤小，是一种安全、有效的治疗包容性腰椎间盘突出症的微创手术。Objective To compare the efficacy of hypothermy plasma radiofrequency ablation nueleoplasty and percutaneous diseeetomy in the treatment of lumbar disc herniation. Methods Sixty cases of lumbar disc herniation, which were diagnosed by physical examination, X ray, CT scanning and MRI, were randomized equally into two groups, and were treated with nucleoplasty or percutaneous discectomy respectively. The clinical outcome of all patients were evaluated according to Macnab rating and VAS scale. Results All the patients were followed-up, with the duration of 6 - 26 months. The total successful rate of the nucleoplasty group and percutaneous discectomy group were 83.33% and 80.00%, respectively, with no statistical significance （ P 〉 0.05 ） ; the average operating time were （ 24.00 ± 2.15 ） min and （47.00 ±3.65 ）min, and the average length of stay were （ 3.20 ± 0.72） day and （6.90 ±1.15 ） day, respectively, all with statistical significance （ P 〈 0.05 ）. Conclusions The successful rate of nucleoplasty and percutaneous discectomy in treating lumbar disc herniation are similar, however, nucleoplasty can reduce the operating time and hospitalization time and is less painful. As a new minimally invasive technique, nucleoplasty is an effective, safe treatment for contained lumbar disc herniation.

关 键 词：腰椎间盘突出症 等离子 髓核成形术 经皮腰椎间盘摘除术 射频消融 

分 类 号：R687.3[医药卫生—骨科学]