后路椎间盘镜治疗单节段腰椎椎间盘突出症5年随访报告  

Five-year follow-up for miroendoscopic diskectomy of single segmental lumber disk herniation

作　　者：俞斌[1] 黄建明[1] 禹宝庆[1] 冯旭[1] 黄旗凯[1] 

机构地区：[1]复旦大学附属浦东医院骨科,上海201399

出　　处：《脊柱外科杂志》2015年第4期219-222,共4页Journal of Spinal Surgery

基　　金：上海市浦东新区卫生和计划生育委员会科技发展专项基金(PW2012A-20)

摘　　要：目的探讨经椎间盘镜手术治疗单节段腰椎椎间盘突出症的中远期疗效及并发症。方法对2004年6月~2009年5月在本院行后路椎间盘镜髓核切除的单节段腰椎椎间盘突出症患者进行随访调查（n=98）,分别于术前,术后3个月、1年、5年对患者行Oswestry功能障碍指数（0swestry disability index,ODI）、疼痛视觉模拟量表（visual analogue scale,VAS）评分;按照Mac Nab评分法评定末次随访（5年）时手术疗效,评价等级（优、良、可、差）。结果 98例患者成功随访5年,术前ODI为（70.8±19.4）%,下腰痛及下肢根性痛VAS评分为（5.4±2.2）分和（7.4±1.8）分;术后5年ODI为（13.1±4.2）%,下腰痛VAS评分为（2.7±1.6）分,下肢根性痛VAS评分（1.9±1.4）分,术前与术后各时间点ODI和VAS评分比较,差异均有统计学意义（P〈0.01）;按照Mac Nab评分法,本组优70例,良19例,可6例,差3例,优良率90.8%（89/98）。结论椎间盘镜手术治疗单节段腰椎椎间盘突出症中远期随访疗效确切,远期并发症和复发率与传统手术相当。Objective To evaluate the mid-long term efficacy of the miroendoscopic discectomy for single segmental lumber disk herniation and to report complications. Methods A total of 98 cases with single segmental lumber disk herniation who underwent miroendoscopic diskectomy（ MED） between June 2004 and May 2009 were followed up. The follow-up data including Oswestry disability index（ ODI） and visual analog scale（ VAS） scores were obtained before surgery and at 3month,1 year,5 years after surgery. The outcomes were also estimated by the Mac Nab criteria at 5 years,which were graded as excellent,good,fair and poor. Results All cases were successfully followed up for 5 years. The preoperative ODI,back and leg pain VAS scores were（ 70. 8 ± 19. 4） %,5. 4 ± 2. 2 and 7. 4 ± 1. 8. The ODI,back and leg pain VAS scores of 5years after surgery were（ 13. 1 ± 4. 2） %,2. 7 ± 1. 6 and 1. 9 ± 1. 4. Adjusted mean differences were statistically significant between each time（ P〈0. 01）. According to Mac Nab criteria,excellent of 70 cases,good of 19 cases,fair of 6 cases and poor of 3 cases,the rate of excellent and good ratio was 90. 8%. Conclusion The mid-long term efficacy of the miroendoscopic discectomy for single segmental lumber disk herniation is good; besides,the complications and recurrence rate is comparable to those of conventional operations.

关 键 词：腰椎 椎间盘移位 内窥镜检查 手术后并发症 

分 类 号：R681.533.1[医药卫生—骨科学]