Quadrant通道下与椎间盘镜下治疗双节段腰椎间盘突出症的比较分析  

Short-term outcomes of microendoscopic discectomy and Quadrant in the management of two adjacent segment lumbar disc herniation

作　　者：滕海军[1] 王亮[1] 郭志良[1] 范丽静[1] 张大海[1] 刘超[1] 王时东[1] 

机构地区：[1]解放军第89医院脊柱外科二区,山东潍坊261021

出　　处：《中国矫形外科杂志》2012年第13期1161-1164,共4页Orthopedic Journal of China

摘　　要：[目的]比较分析采用Quadrant可扩张通道与后路椎间盘镜(microendoscopic discectomy MED)下治疗邻近双节段同侧腰椎间盘突出症的临床效果及优缺点。[方法]2008年7月～2010年12月,22例邻近双节段同侧腰椎间盘突出症患者采用Quadrant可扩张通道手术治疗;24例患者采用显微内窥镜椎间盘切除术治疗作为对照。疗效评定按照目测视觉类比评分法(VAS评分)和改良MacNab分级评定,比较两组手术时间、术中失血量、住院时间及临床效果。[结果]两组手术时间有显著性差异,出血量、住院时间差别无统计学意义。VAS疼痛目测评分法术前术后比较P<0.05,按改良MacNab分级评定,Quadrant组优15例,良6例,MED组优18例,良5例,两组间无统计学差异。[结论]Quadrant通道下治疗邻近双节段同侧腰椎间盘突出症也是一种安全有效的微创手术方法,与MED手术比较疗效相近,可缩短手术时间,适应证更广。[Objective] To compare the clinical value between microendoscopic discectomy （MED） and Mast Quadrant retractor in the management of two adjacent segment lumbar disc herniation. [ Methods ] Twenty - four patients were treated with MED, and 22 controls were treated with Quadrant from July 2008 to December 2010. Before operation, radiologieal evaluation including X - Ray , CT and MRI was performed. Operation time, blood loss, hospital stay time and therapeutic effects were recorded. [ Results] All the patients were successfully treated without any complications during and after operation. The average operating time was significant difference between MED and Quadrant groups. There were no differences in blood loss and hospital stay time. According to modified MacNab criteria, 15 patients and 6 patients in the Quadrant group had excellent and good results, and 18 patients and 5 patients in the MED group had excellent and good results. The outcome was similar between groups. [ Conclusion] MAST Quadrant retractor is a safe and effective minimally invasive surgical technique in treating two ad- jacent segment lumbar disc herniation. Compared with MED, Quadrant appears to offer a similar short - term clinical outcome , but has shorter operation time and wider indications.

关 键 词：椎间盘镜 MAST QUADRANT 微创 双节段腰椎间盘突出症 

分 类 号：R687.3[医药卫生—骨科学]