椎间孔镜下神经根减压松解术和椎板间开窗髓核摘除术治疗单节段单侧腰椎间盘突出症的临床效果观察  

Clinical Observation of Treatment of Single-segment Unilateral Lumbar Disc Herniation with Intervertebral Foramen Decompression with Nerve Root Decompression and Interlaminar Nucleus Pulposus

作　　者：丁华[1] 袁即山[1] 汪雷[1] 蒋勤益 徐勇 周辉辉[1] DING Hua;YUAN Ji-shan;WANG Lei;JIANG Qin-yi;XU Yong;ZHOU Hui-hui(Affiliated People's Hospital of Jiangsu University,Zhenjiang,Jiangsu Province,212002 China)

机构地区：[1]江苏大学附属人民医院

出　　处：《世界复合医学》2019年第12期1-3,15,共4页World Journal of Complex Medicine

摘　　要：目的探讨椎间孔镜下神经根减压松解术和椎板间开窗髓核摘除术治疗单节段单侧腰椎间盘突出症的临床效果。方法选取该院2015年1月-2019年1月收治的80例单节段单侧腰椎间盘突出症患者为研究对象,将患者随机分为研究组和对照组,每组40例。研究组予椎间孔镜下神经根减压松解术,对照组予椎板间开窗髓核摘除术。结果治疗后研究组切口长度(0.8±0.5)cm、手术时间(45.1±5.2)min、出血量(14.5±3.8)mL和平均住院日(5.2±1.3)d显著低于对照组的(5.0±0.5)cm、(82.3±9.1)min、(48.3±2.7)mL、(10.3±2.2)d,两组数据差异有统计学意义(t=14.310、15.260、28.150、5.640, P<0.05);研究组术后6个月JOA评分、ODI评分、VAS评分分别为(27.1±3.8)分、(5.2±0.2)分、(1.9±0.4)分,对照组分别为(29.0±1.5)分、(4.8±0.7)分、(1.6±0.7)分,与术前比两种治疗方法均有效,但术后两组间疗效差异无统计学意义(t=0.250、0.590、0.870,P>0.05)。结论椎间孔镜下神经根减压松解术和椎板间开窗髓核摘除术对单节段单侧腰椎间盘突出症均治疗有效,并且疗效相似,但椎间孔镜下神经根减压松解术的切口长度、手术时间、出血量和平均住院日均短于椎板间开窗髓核摘除术,因此椎间孔镜下神经根减压松解术对患者损伤更小,值得推广。Objective To investigate the clinical effect of intervertebral foramen decompression and nucleus pulposus extraction in the treatment of single-segment unilateral lumbar disc herniation. Methods Eighty patients with single-segment unilateral lumbar disc herniation admitted to the hospital from January 2015 to January 2019 were enrolled. The patients were randomly divided into study group and control group, with 40 cases in each group. The study group underwent intervertebral foramen decompression and the control group was treated with interlaminar fenestration. Results It showed that the incision length(0.8 ±0.5)cm, operation time(45.1±5.2)min, blood loss(14.5±3.8)mL and average hospitalization day(5.2±1.3)d in the study group were significantly lower than the control group(5.0±0.5)cm,(82.3±9.1)min,(48.3±2.7)mL,(10.3±2.2)d,the difference between the two groups was statistically significant(t=14.310,15.260,28.150,5.640, P<0.05);the study group 6 months postoperative JOA score, ODI score, VAS scores were(27.1 ±3.8)points,(5.2±0.2)points,(1.9±0.4)points, and the control group were(29.0±1.5)points,(4.8 ±0.7)points,(1.6±0.7)points. All treatments were effective, but there was no significant difference between the two groups(t=0.250,0.590,0.870,P>0.05). Conclusion Intervertebral foramen decompression and nucleus pulposus extraction are effective in the treatment of single-segment unilateral lumbar disc herniation, and the curative effect is similar, but the nerve root reduction under intervertebral foramen The length of the incision, the operation time, the amount of bleeding, and the average hospitalization time of the compression are shorter than the interlaminar nucleus pulposus removal. Therefore, the nerve root decompression of the intervertebral foramen is less harmful to the patient, and it is worth promotion.

关 键 词：腰椎间盘突出症 椎间孔镜下神经根减压松解术 椎板间开窗髓核摘除术 临床效果 

分 类 号：R274.34[医药卫生—中医骨伤科学]