椎间盘镜下纤维环缝合修复术在腰椎间盘突出症中的应用  

Application of microendoscopic discectomy associated with annulus fibrosus repair in prolapse of lumbar intervertebral disc

作　　者：李东[1] 常志泳 陈刚[1] 李开华[1] 

机构地区：[1]江苏省中医院南京中医药大学附属医院骨伤科,江苏南京210029

出　　处：《中国医药导报》2017年第30期93-96,共4页China Medical Herald

摘　　要：目的探讨椎间盘镜下纤维环缝合修复术在单节段腰椎间盘突出症患者中的应用效果。方法回顾性分析江苏省中医院2014年5月~2015年12月行椎间盘镜下纤维环缝合修复术患者19例的临床资料,采用视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)和MacNab标准对术后疗效进行评价。结果所有患者均获随访,随访时间为18~37个月,平均(27.30±5.24)个月,无一例复发。术前、术后3个月、术后1年及末次随访腰腿痛VAS评分分别为(7.11±0.86)、(1.58±1.03)、(1.37±0.81)、(1.26±0.73)分,术后各时间点VAS评分均显著低于术前(均P<0.01)。术前、术后3个月、术后1年及末次随访ODI分别为(63.73±10.86)%、(22.26±7.58)%、(16.47±3.34)%和(14.21±3.67)%,术后各时间点ODI均低于术前(均P<0.01)。采用MacNab标准评价近期疗效:优14例,良4例,可1例,优良率为94.7%。结论椎间盘镜下纤维环缝合修复术是单节段腰椎间盘突出症的一种有效微创治疗方法 ,严格掌握适应证有利于获得满意的疗效和较低的复发率。Objective To investigate the application effect of microendoscopic discectomy associated with annulus repair in patients with single segment of prolapse of lumbar intervertebral disc. Methods The clinical data of 19 cases of patients with prolapse of lumbar intervertebral disc underwent microendoscopic discectomy associated with annulus fibrosus repair treated in Jiangsu Province Hospital of Traditional Chinese Medicine from May 2014 to December 2015 was analyzed retrospectively. The postoperative effects were evaluated by visual analogue score （VAS）, Oswestry disability index （ODI） and MacNab standard. Results All patients completed the follow-up, and the mean follow-up was （27.30±5.24） months （18-37 months）. No recurrence was found in 19 cases. The scores of VAS before operation, after operation for 3 months, after operation for 1 year and at the final follow-up were （7.11±0.86）, （1.58±1.03）, （1.37±0.81）, （1.26± 0.73） scores respectively. The scores of each postoperative time point were all lower than those before operation, with highly statistically significant differences （all P 〈 0.01）. The ODI before operation, after operation for 3 months, after operation for 1 year and at the final follow-up were （63.73±10.86）%, （22.26±7.58）%, （16.47±3.34）% and （14.21±3.67）% respectively. The scores of each postoperative time points were all lower than those before operation, with highly statis tically significant differences （all P 〈 0.01）. Short term clinical efficacy was evaluated by MacNab standard： 14 cases were excellent, 4 cases were good and 1 case was better. The excellent and good rate was 94.7%. Conclusion Microendoseopic discectomy associated with annulus fibrosus repair is an effective mini-invasive therapy for the treatment of single segment of prolapse of lumbar intervertebral disc. Controlling the indications strictly is helpful to achieve the satisfactory curative effect and low recurrence rate.

关 键 词：腰椎间盘突出症 椎间盘镜下髓核摘除术 纤维环缝合修复术 

分 类 号：R687.3[医药卫生—骨科学]