后路椎间盘镜手术治疗青壮年腰椎间盘突出合并椎管狭窄的应用及相关因素分析  

Influencing Factors on Microendoscopic Discectomy for Young Adults with Lumbar Disc Herniation of Spinal Stenosis

作　　者：袁智锐 赵晓东 谢大志 

机构地区：[1]广东省佛山市禅城区中心医院,广东佛山528031

出　　处：《中国医学创新》2015年第22期61-63,共3页Medical Innovation of China

基　　金：国家自然科学基金资助项目(81060165)

摘　　要：目的：观察后路椎间盘镜手术治疗青壮年腰椎间盘突出合并椎管狭窄的临床疗效,同时对影响疗效的相关因素进行分析。方法：回顾性分析2011年7月-2013年8月在本院骨外科进行后路椎间盘镜手术治疗的56例腰椎间盘突出合并椎管狭窄的青壮年患者的临床资料,观察临床效果,并对可能影响疗效的相关因素进行分析。结果：所有患者均顺利完成手术,术后随访4～24个月,优43例,良11例,可2例,差0例,优良率96.4%;VAS改善率92.3%。单因素分析发现病程、发病诱因、突出类型、突出位置与腰椎间盘突出症预后差异有统计学意义（P〈0.05）,其中多因素Logistic回归分析表明病程、发病诱因是影响疗效的危险因素。结论：后路椎间盘镜手术对青壮年腰椎间盘突出症的治疗疗效显著,有创伤小、恢复快等优点,可作为首选手术方法之一。此外病程和发病诱因是影响该术式疗效的危险因素,应对其进行及时干预,以提高疗效。Objective： To observe posterior discectomy for lumbar disc surgery clinical efficacy in young adults with spinal stenosis, while the relevant factors affecting the efficacy. Method： A retrospective analysis on clinical data from July 2011 to August 2013 in our hospital orthopedic surgery performed posterior discectomy surgery 56 lumbar disc herniation with spinal stenosis young patients, to observe clinical effects, and analyze influence factors. Result： All the patients successfully completed surgery, postoperative follow-up of 4 to 24 months, excellent in 43 cases, good in 11 cases, fair 2 cases and no poor case. The good rate was 96.4%, and VAS improvement rate was 92.3%. Univariate analysis showed that duration, predisposing factors, highlight the type of lumbar disc herniation in a prominent position and the prognosis was significant （ P〈0.05 ）, which Multivariate Logistic regression analysis showed that duration, predisposing factors were risk factors on the efficacy of microendoscopic discectomy. Conclusion： Posterior discectomy for lumbar disc herniation treatment of young adults significant effect, there is less trauma, quicker recovery, can be used as one of the preferred surgical method. Moreover course and risk factors predisposing factors affecting the surgical efficacy, and should be a timely intervention to improve the outcome.

关 键 词：后路椎间盘镜手术 青壮年 腰椎间盘突出 椎管狭窄 相关因素 

分 类 号：R687.3[医药卫生—骨科学]