可扩张通道下髓核摘除术联合纤维环修复技术治疗腰椎间盘突出症的疗效观察  被引量:2

Effect of minimally invasive passage of nucleus pulposus combined with fibrous ring repair in the treatment of protrusion of lumbar intervertebral disc

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作  者:胡亚宁[1] HU Ya-ning(Department of Orthopedics,the First Hospital of Shijiazhuang,Shijiazhuang,Hebei,050031,China.)

机构地区:[1]石家庄市第一医院骨一科,河北石家庄050031

出  处:《颈腰痛杂志》2018年第3期309-312,共4页The Journal of Cervicodynia and Lumbodynia

摘  要:目的观察Quadrant可扩张通道下髓核摘除术治疗腰椎间盘突出症(lumbar disc herniation,LDH)的疗效,并探讨术中予以纤维环修复的临床价值。方法随机选择2013-09-2015-07行Quadrant可扩张通道下髓核摘除术治疗的LDH患者76例纳入本研究,依据术中对纤维环的处理方式不同,将其分为两组:缝合组39例,在髓核摘除的同时,均予以纤维环缝合处理;对照组37例,仅单纯予以髓核摘除手术,纤维环破裂口不予处理。结果与对照组相比,缝合组的手术时间略长、术中出血量略多,但组间差异无统计学意义(P>0.05);术后3个月、2年时,两组患者的VAS评分和ODI指数均显著改善(P<0.05),但组间无显著性差异(P>0.05)。截至术后2年时,缝合组2例、对照组5例再次复发LDH,组间对比,缝合组的复发率显著低于对照组(5.13%VS 13.51%,P<0.05)。结论在Quadrant通道下髓核摘除手术中予以纤维环缝合处理,并未显著增加操作难度,有效重建了纤维环的完整性,有助于降低术后再次复发率。Objective To observe the curative effect of nucleus pulposus removal under Quadrant expandable channel for lumbar disc herniation(LDH), and to explore the clinical value of intraoperative fibrous annulus repair. Methods From September 2013 to July 2015, 76 LDH patients who received Quadrant expandable channel discectomy treatment were randomly selected in the study. According to the different treatment on fiber ring, the patients were divided into two groups. Thirty-nine cases in the suture group were treated by discectomy combined with fiber ring suture. Thirty-seven cases in the control group were only treated with discectomy, fibrous ring rupture was not treated. Results Compared with the control group, the operation time of the suture group was slightly longer, intraoperative blood loss was more, but there were no significant differences between the two groups(P〈0.05). Three months and 2 years after surgery, the VAS score and ODI index in two groups were improved significantly(P〉0.05), but the difference was not significant between the two groups(P〉0.05).Up to 2 years after operation, 2 cases in the suture group and 5 cases in the control group recurred again. The recurrence rate in the suture group was significantly lower than that in the control group(5.13% vs 13.51%, P〈0.05). Conclusion Application of annulus suture in the operation of nucleus pulposus under Quadrant channel has not significantly increased the difficulty of operation, effectively reconstructed the integrity of the annulus fibrosus, and reduced the recurrence rate after operation.

关 键 词:腰椎间盘突出症 髓核摘除术 Quadrant可扩张通道 纤维环缝合技术 

分 类 号:R681.5[医药卫生—骨科学]

 

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