椎间盘镜后路摘除术与椎间孔镜下髓核摘除治疗腰椎间盘突出症的疗效对比分析  

Comparative analysis of the curative effect of posterior discectomy under endoscopy and nucleus pulposus enucleation under endoscopy in treating lumbar disc herniation

作　　者：刘美霞[1] 于英楠[1] 聂晓英[1] 翟田敏[1] LIU Mei-xia;YU Ying-nan;NIE Xiao-ying(Department of Minimally Invasive Spine Surgery,The Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 000059,China)

机构地区：[1]内蒙古医科大学第二附属医院微创脊柱外科,内蒙古呼和浩特000059

出　　处：《中国医学装备》2019年第2期71-74,共4页China Medical Equipment

摘　　要：目的:对比运用椎间盘镜后路摘除与椎间孔镜下髓核摘除治疗腰椎间盘突出症的疗效及对患者预后的影响。方法:选取医院收治的194例腰椎间盘突出症患者,采用随机数表法将其分为观察组和对照组,每组97例。对照组采用椎间盘镜后路摘除术治疗,观察组采用椎间孔镜下髓核摘除术,比较两组的临床疗效、各项手术指标水平、手术前后日本骨科协会(JOA)评分、术后复发率以及并发症发生情况。结果:两组手术的优良率比较无明显差异;观察组手术时间明显长于对照组,而术中出血量、术后下床时间及住院时间明显少于对照组,其差异有统计学意义(t=6.172,t=45.052,t=7.613,t=6.307;P<0.05);两组术前、术后3个月、6个月的JOA评分比较,差异均无统计学意义(t=0.306、t=0.979、t=0.547;P>0.05);两组术后复发率、神经损伤率和椎间隙感染率比较,差异均无统计学意义(x^2=1.052,x^2=0.339,x^2=2.021;P>0.05)。结论:椎间盘镜后路摘除治疗腰椎间盘突出症手术时间短,但椎间孔镜下髓核摘除术对患者造成的创伤更小,术后恢复较快,椎间孔镜下髓核摘除术可适用于腰椎间盘突出症。Objective:To compare the curative effect of posterior discectomy under endoscopy and nucleus pulposus enucleation under endoscopy in treating lumbar disc herniation and the influence of different methods on the prognosis of patients.Methods:194 patients with lumbar disc herniation were enrolled in this research and were divided into observation group(97 cases)and control group(97 cases)according to random number table.And these patients of control group were treated by using posterior discectomy under endoscopy,and ones of observation group were treated by using nucleus pulposus enucleation under endoscopy.And the clinically curative effect,the level of each surgical indicator,the score of Japanese orthopaedic association(JOA)pre and post operation,postoperative recurrence rate and complication of the two groups were compared.Results:The difference of good rate between two groups was no significant.The operation time of observation group was significantly longer than that of control group,and the amount of bleeding during operation,the time of getting out of bed post operation and the time of hospitalization of observation group were significantly shorter than those of control group(t=6.172,t=45.052,t=7.613,t=6.307,P<0.05).The JOA scores of two groups before operation,and that of 3 months and 6 months after operation were compared,and there were no significant differences between the two groups(t=0.306,t=0.979,t=0.547,P >0.05).Besides,the differences of recurrence rate,nerve injury rate and intervertebral infection rate between the two groups were no significant(x^2=1.052,x^2=0.339,x^2=2.021,P >0.05).Conclusion:The operation time of posterior discectomy under endoscope for lumbar disc herniation is shorter,while the wound of nucleus pulposus enucleation under endoscopy for patients is smaller and its postoperative recovery is faster.And the nucleus pulposus enucleation under endoscopy is suitable for lumbar disc herniation.

关 键 词：腰间盘突出症 椎间盘镜后路摘除 预后 

分 类 号：R681.53[医药卫生—骨科学]