比较椎间盘镜与椎板开窗髓核摘除术治疗单阶段腰椎间盘突出症的近期疗效  

Compare the short term effect of the treatment of single stage lumbar disc herniation by the microendoscopic discectomy and fanestration discectomy

作　　者：徐斌[1] 安伟[1] 方浩[2] 滕勇[1] 马在松[1] 张春浩[1] 马锐[1] 

机构地区：[1]兰州军区乌鲁木齐总医院全军骨科中心,乌鲁木齐新疆830000 [2]新疆医科大学研究生学院,乌鲁木齐新疆830000

出　　处：《生物骨科材料与临床研究》2016年第4期46-48,共3页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的比较椎间盘镜（Microendoscopic Discectomy,MED）与椎板开窗（Fanestration Discectomy,FD）镜下髓核摘除术,在治疗单节段腰椎间盘突出症（Lumbar Disc Herniation,LDH）近期疗效上的差异。方法回顾性收集2011年6月-2013年6月,我院单节段性LDH行髓核摘除手术的患者97例,MED 65例,FD 32例,收集年龄、性别、慢性疾病、术中出血量、手术时间、手术并发症及JOA评分。结果随访6个月-4年,17例失访,失访率为17.89%。MED组与FD组比较具有术出血量较少、术后并发症发生率低、术后1周和2周的JOA优良率高,但手术时间较长,差异均统计学意义（P〈0.05）;两组在术中相关并发症（硬膜囊破裂、神经根损伤）、术后6个月JOA优良率及随访终末期术后复发率的比较中,统计学差异不显著（P〉0.05）。结论 MED和FD均可缓解LDH症状,虽MED具有手术时间长,但MED具有术中出血量少及术后并发症及低的特点,值得临床推广应用。Objective To compare the short-term efficacy of the MED（Microendoscopic Discectomy） and FD（Fanestration Discectomy） in the treatment of lumbar disc herniation.Methods Retrospective analysis of Jun 2011 to Jun2013,97 patients with single segmental LDH in our hospital（MED 65 patients,FD 32 patients）.The age,gender,chronic disease,bleeding volume,operation time,complications and JOA score were collected.Results After 6 months to 4 years,17 cases lost,follow-up rate of 17.89%.MED group and FD group compared with less bleeding,postoperative complication rate was low,1 weeks and 2 weeks of excellent high rate,but the operation time is longer,the difference was statistically significant（P〈0.05） two groups in the postoperative complications（dural rupture,nerve root injury）,postoperative 6 months JOA rate and the recurrence rate of postoperative recurrence rate was not significant（P〈0.05）.Conclusion Both MED and FD can alleviate the symptoms of LDH,although MED has a long operation time,but MED has less blood loss and postoperative complications and low characteristics,it is worthy of clinical application.

关 键 词：椎间盘镜 椎板开窗 髓核摘除 单节段 腰椎间盘突出症 

分 类 号：R687.3[医药卫生—骨科学]