不同微创手术方式治疗腰椎间盘突出症的对比研究  

Contrastive study of different minimally invasive surgery for lumbar intervertebral disc herniation

作　　者：宋晋刚[1] 崔易坤[1] 尹振宇[1] 赵兵[1] 黄海峰[1] 羊刚毅[1] Song Jingang;Cui Yikun;Yin Zhenyu(The Spinal Surgery Department of the Central Hospital of Mianyang city,Mianyang Sichuan,621000,China)

机构地区：[1]四川省绵阳市中心医院脊柱外科,四川绵阳621000

出　　处：《生物骨科材料与临床研究》2018年第5期45-48,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨治疗腰椎间盘突出症的三种微创手术方法的有效性和适用性。方法回顾性分析我院脊柱外科2015年12月~2016年12月治疗的单节段腰椎间盘突出症手术患者120例,其中小切口开窗60例,微创通道30例,椎间孔镜30例。对手术时间、出血量、切口长度、术后下床时间、住院天数、腰腿痛VAS评分、改良Macnab疗效评定进行比较,数据行统计学分析。结果术后1、6、12月定期随访,各组病例在手术时间、出血量、切口长度、术后下床时间、住院天数有显著性差异(P<0.05)。各组病例腰腿痛VAS评分、改良Macnab疗效评定无显著性差异(P>0.05)。结论三种微创手术方式均能有效治疗腰椎间盘突出症。比较而言,椎间孔镜技术具有创伤更小、恢复更快等优势,但设备及技术要求高。临床工作中应根据医院条件及医师技术选择适当的微创手术方式。Objective To explore the effectiveness and applicability of three minimally invasive surgical methods for treatment of lumbar intervertebral disc herniation. Methods Retrospective analysis of spine surgery in Dec 2015 ~ Dec 2016 for the treatment of 120 patients with single segmental lumbar intervertebral disc protrusion, 60 cases with small incision open window surgery, minimally invasive surgery channel 30 cases, 30 cases of percutaneous endoscopic lumbar discectomy. The time of operation, the amount of bleeding, the length of incision, the time to get out of bed after surgery,the days in hospital, the VAS score of the lumbar leg pain and the improvement of the efficacy evaluation of Macnab were compared and analyzed statistically. Results All patients were followed by 1、6、12 months. There were significant differences in the time of operation, the amount of bleeding, the length of the incision, the time to get out of bed after surgery and the days in hospitalization after surgery（P〈0.05）. There was no significant difference（P〉0.05） in patients with lumbar pain VAS score and improved Macnab efficacy in each group. Conclusion Three minimally invasive methods all can effectively treat lumbar intervertebral disc herniation. In comparison, percutaneous endoscopic lumbar discectomy has the advantages of less trauma and faster recovery, but the equipment and technology require a high degree. In clinical work, appropriate minimally invasive surgery should be selected according to hospital conditions and physician＇s technology.

关 键 词：微创 椎间盘突出症 椎间孔镜 小切口 

分 类 号：R681.53[医药卫生—骨科学]