改良小切口开窗与椎管镜技术行腰椎间盘摘除术治疗腰椎间盘突出症的疗效观察  

Clinical effect of modified small incision fenestration and microendoscopic discectomy in the treatment of lumbar disc herniation

作　　者：曹华平 李永忠 CAO Hua-ping;LI Yong-zhong(Department of Orthopaedics,the Second People＇ s Hospital of Yichang,Yichang,Hubei,443000,China)

机构地区：[1]宜昌市第二人民医院骨科,湖北宜昌443000

出　　处：《颈腰痛杂志》2018年第3期330-332,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨改良小切口开窗行椎间盘摘除手术(modified fenestration discectomy,MFD)与椎管镜技术(micro endoscopic discectomy,MED)的疗效差异。方法 2012-05-2014-05,纳入100例单节段腰椎间盘突出症患者,依据手术方案不同,分为MED组57例和MFD组43例,对患者手术时间、术中出血量,以及术前、术后1个月、6个月和2年的VAS、JOA评分进行比较。结果(1)围手术期指标:MED组的手术时间较MFD组明显延长(P<0.05),但两组术中出血量较为相近(P>0.05);(2)JOA评分;两组间对比,术前和术后各时间点的JOA评分均无显著性差异(P>0.05)。(3)两组术后的腰部和下肢疼痛VAS评分均较术前显著下降(P<0.05)。组间比较,两组下肢疼痛VAS评分在各时间点的变化均较为相近(P>0.05);MFD组术后1个月的腰痛VAS评分明显高于MED组(P<0.05)。结论采用MFD技术治疗单纯的腰椎间盘突出症,其切口小、创伤少,可取得与MED技术相近的手术效果,但其术中操作简便、手术时间更短。Objective To investigate the curative effect of microendoscopic discectomy system（MED） and modified small incision fenestration for discectomy surgery（MFD） in the treatment of lumbar disc herniation. Methods From May 2012 to May 2014, a total of 100 patients with lumbar disc herniation were randomly divided into MED group（57 cases） and MFD group（43 cases）. The amount of hemorrhage, time of surgery, and VAS, JOA scores at preoperation, postoperative 1 month, 6 months and 2 years were compared. Results（1） The perioperative index： the operation time of MED group was significantly longer than MFD group（P〈0.05）, but there was no significant difference between the two groups in intraoperative blood loss（P〈0.05）.（2） JOA score： There was no significant difference between the two groups in the preoperative and postoperative JOA scores（P〈0.05）.（3） The VAS scores of pain in waist and lower limbs in two groups were significantly lower than before operation（P〈0.05）. The lower extremity pain VAS score changes between two groups at each time point were similar（P〈0.05）. One month after operation, the low back pain VAS score in MFD group was significantly higher than that in MED group（P〈0.05）. Conclusion MFD technique in the treatment of simple lumbar disc herniation has small incision, less trauma, it can achieve similar effect as MED technology, but its operation is simple,and operation time is shorter.

关 键 词：腰椎间盘突出症 椎管镜 改良小切口开窗手术 

分 类 号：R681.53[医药卫生—骨科学]