经皮椎间孔镜与椎板开窗术治疗腰椎间盘突出症的疗效对比  

Comparative study of percutaneous endocopic lumbar discectomy and fenestration discectomy for mono-segment lumbar disc herniation

作　　者：李兴艳[1] 张津铭[1] 叶亚平[1] 李文凯[1] 鲍远[1] 陈安民[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院骨科1病区,湖北武汉430030

出　　处：《中国骨与关节损伤杂志》2015年第5期467-469,共3页Chinese Journal of Bone and Joint Injury

基　　金：百色市科学研究与技术开发项目(20120112)

摘　　要：目的比较经皮内镜和椎板开窗髓核摘除术治疗单节段单侧腰椎间盘出症的临床效果及优缺点。方法回顾性分析自2011-01—2014-01诊治的278例腰椎间盘突出症,采用经皮内镜腰椎间盘切除术治疗142例,采用椎板开窗髓核摘除术治疗136例。结果椎板开窗髓核摘除术出血量多和时间短,并发症多,2组比较差异有统计学意义(P<0.05);术后2周、3个月和6个月Macnab标准优良率2组比较,经皮内镜腰椎间盘切除术优于椎板开窗髓核摘除术,差异均有统计学意义(P<0.05)。结论 2种术式都能有效缓解腰椎间盘突出症患者的症状,但经皮内镜腰椎间盘切除术后并发症发生率低,是理想的微创治疗腰椎间盘突出症的方法。Objective To compare the clinical effects of peroutaneous endocopic lumbar discectomy （PELD） and fenestration discectomy （FD） for mono segment unilateral lumbar disc herniation （LDH）. Methods A total of 278 cases of mono segment unilateral lumbar disc herniation receiving surgery between Jan. 2011 and Jan. 2014 were analyzed. Of which, 142 cases underwent PELD while 136 cases received FD. Results Two groups of patients all had smooth surgery. The amount of bleeding was large while the time was short for FD and the intraoperative complications of FD was multiple, the difference in two groups was statistically significant（P 〈0.05）. The Macnab criteria excellent rate in two weeks, three months and six months after operation between the two groups showed that the PELD group was better than FD, where the differences were statistically significant （P 〈0.05）. Conclusion Both PELD and FD could effectively relieve the symptoms of the lumbar disc herniation and improve Mancnab standard excellent rate, and both are satisfying methods for treating LDH. However the incidence of postoperative compliances by PELD is lower, which is an ideal minimally invasive method for LDH.

关 键 词：椎间盘突出 经皮内镜腰椎间盘切除术 椎板开窗髓核摘除术 

分 类 号：R687.3[医药卫生—骨科学]