经改良的Jaslow技术治疗复发性腰椎间盘突出症  

Treatment of recurent lumbar disc herniation with the modified Jaslow technique

作　　者：袁健东[1] 王靖[1] 傅强[2] 

机构地区：[1]温州医学院附属第一医院骨科,浙江温州325000 [2]第二军医大学附属长海医院骨科,上海200433

出　　处：《中国骨伤》2010年第11期832-834,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:采用经改良的Jaslow技术治疗复发性腰椎间盘突出症,评价其临床疗效。方法:自2002年1月至2008年12月,采用改良Jaslow技术进行手术治疗62例复发性腰椎间盘突出症患者,男42例,女20例;年龄36～70岁,平均53.6岁。首次术式:扩大开窗20例,单侧半椎板切除20例,双侧半椎板切除8例,全椎板切除14例。手术节段:L3,42例,L4,532例,L5S115例,L3,4、L4,53例,L4,5、L5S110例。临床症状主要为下腰痛和放射痛。通过手术前后的JOA评分变化(包括主观症状、自理能力、疼痛等方面)、以及手术节段的椎间隙高度比、植骨融合情况评价临床疗效。结果:62例均获随访,时间1～5年,平均3年。末次随访影像学检查椎间隙高度比由术前(62.5±10.4)%恢复至术后(90.5±10.3)%,融合率96.8%(60/62)。JOA评分由(10.42±2.50)提高至末次随访时(24.26±2.35)(P<0.001)。疗效结果:优39例,良14例,中9例。结论:改良的Jaslow技术治疗复发性腰椎间盘突出症减压充分、椎间融合可靠,手术安全性高,临床疗效满意,是一种比较理想的手术方法。Objective：To investigate the results of using the modified Jaslow technique to treat the recurent lumbar disc herniation. Methods：From January 2002 to December 2008,62 patients with recurent lumbar disc herniation were treated with a modified Jaslow technique. There were 42 males and 20 females with an average age of 53.6 years old,ranging from 36 to 70 years. The primary surgical procedures were enlarged fenestration in 20 cases,unilateral semi laminectomy in 20 cases,bilateral semi laminectomy in 8 cases and total laminectomy in 14 cases. The procedures were performed at L3,4 level in 2 cases, L4,5 in 32 cases,L5S1 in 15 cases,L3,4-L4,5 in 3 cases and L4,5-L5S1 in 10 cases respectively. The clinical symptoms included low back pain and radicular pain. Pre and postoperative JOA score（including subjective symptoms,self care ability and pain）,ratio of disc height and the fusion condition of the involved segments were applied to assess clinical outcome. Results：All patients were followed up for 1 to 5 years（averaged 3 years）. The space height ratio increased from（62.5±10.4）% to（90.5±10.3）%,fusion rate was 96.8%（60 / 62） at the last follow up. Mean JOA score was（10.42±2.50） preoperative,improved to（24.26±2.35） at last follow up（P0.001）. The clinic results was excellent in 39 cases,good in 14,fair in 9. Conclusion：The modified Jaslow technique was a good alternative method for the treantment of recurent lumbar disc herniation with complete decompression, solid interbody fusion and satisfactory clinical result.

关 键 词：腰椎 椎间盘移位 复发 脊柱融合术 外科手术 

分 类 号：R274.915.3[医药卫生—中西医结合]