椎板开窗髓核摘除纤维环缝合术治疗腰椎间盘突出症  

Fenestration discectomy associated with annulus repair in treatment of lumbar disc herniation

作　　者：李学涛 宋宏阁 刘明成[3] 

机构地区：[1]郑州市第十六人民医院骨科,452470 [2]郑州市第六人民医院骨科,450000 [3]甘肃省天水市第一人民医院骨科,741600

出　　处：《中国实用医刊》2017年第17期66-69,共4页Chinese Journal of Practical Medicine

摘　　要：目的 探讨椎板开窗髓核摘除纤维环缝合术治疗腰椎间盘突出症的疗效及近、中期随访效果。 方法 选取腰椎间盘突出症患者64例，依据建档顺序分为两组，每组32例。对照组采用椎板开窗髓核摘除术，研究组采用椎板开窗髓核摘除纤维环缝合术，术后12、18个月进行随访。术后统计对比两组手术情况及并发症发生率，分析术前及术后第12、18个月随访期间两组功能障碍评分（ODI）、疼痛评分（VAS）及硬膜外压痕变化情况，术后12个月统计对比两组治疗优良率。 结果 两组切口长度、手术用时、术中失血量、住院时间比较差异未见统计学意义（P〉0.05）；术前两组ODI评分、VAS评分及硬膜外压痕比较差异未见统计学意义（P〉0.05）。术后12、18个月，研究组ODI评分、VAS评分低于对照组，硬膜外压痕小于对照组，差异有统计学意义（P〈0.05）。研究组治疗优良率[84.38%（27/32）]高于对照组[62.50%（20/32）]，差异有统计学意义（P〈0.05）；研究组并发症发生率[9.37%（3/32）]与对照组[15.61%（5/32）]比较差异未见统计学意义（P〉0.05）。 结论 椎板开窗髓核摘除纤维环缝合术治疗腰椎间盘突出症效果显著，可有效缓解患者疼痛感及功能障碍情况，提高治疗优良率，且不会对手术用时及失血量产生不利影响，安全性较高，具有推广价值。Objective To investigate the therapeutic effect and the near and mid-term follow-up results of fenestration discectomy associated with annulus repair on lumbar disc herniation. Methods Sixty-four patients with lumbar disc herniation were selected. According to the filing order, they were divided into two groups, with 32 cases in each group. The control group was treated by fenes- tration discectomy, and the study group was treated by fenestration discectomy associated with annulus re- pair, and the patients were followed up at 12th and 18th month after operation. After operation, the oper- ation and complication rate of the two groups were compared ; the oswestry disability index （ ODI）, visual analogue pain score （VAS） and the change of epidural impression were observed between the two groups before and at twelfth, eighteenth month after operation, and the excellent and good rate was compared be- tween the two groups at the end of the operation. Results There was no significant difference in incision length, operative time, intraoperative blood loss and hospitalization time between the two groups （P 〉 0.05 ） ; there was no significant difference between the two groups in ODI score, VAS score or epidural impression before operation （ P 〉 0. 05 ）. The ODI score and VAS score of the study group were lower than those of the control group at 12th and 18th month after operation, and the epidural impression was less than that of the control group, the differences were significant （ P 〈 0.05 ）. The excellent and good rate of treatment group was 84.38% （ 27/32 ） , which was higher than that of control group [ 62.50% （20/32） ], study group the difference was significant （P 〈 0.05 ）. and 15.61% （5/32） in the control group The complication rate was 9.37% （3/32） in the , the difference was not significant （P 〉 O. 05 ）. Conclusions Fenestration discectomy associated with annulus repair has significant effect on lumbar disc herniation, which can effectively alleviate the p

关 键 词：椎板开窗髓核摘除纤维环缝合术 腰椎间盘突出症 预后 应用价值 

分 类 号：R687.3[医药卫生—骨科学]