显微镜下通道技术治疗腰椎间盘突出症的疗效  

The effect of microscope operation assisted with Quadrant channel technique for treatment of lumbar disc herniation

作　　者：唐建华 赵丽丽 黄春明[2] 钟诚凡[2] 刘付仟 TANG Jian-hua;ZHAO Li-li;HUANG Chun-ming;ZHONG Cheng-fan;LIU Fu-qian(Dept of Orthopaedics,Chang′an Hospital of Dongguan City,Dongguan,Guangdong 523843,China)

机构地区：[1]东莞市长安医院骨科,广东东莞523843 [2]高州市人民医院骨一科,广东高州525200

出　　处：《临床骨科杂志》2020年第6期792-795,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨显微镜下通道技术治疗腰椎间盘突出症的临床疗效。方法采用微创通道下靶点穿刺、显微镜下开窗摘除脱出髓核治疗20例单节段腰椎间盘脱出症患者。手术前后采用疼痛VAS评分评估疼痛程度,采用ODI评分进行功能评估。末次随访时采用MacNab标准评估临床疗效。结果患者均获得随访,时间6~18个月。无手术并发症,切口均一期愈合。VAS评分术后3 d、2周、3个月及末次随访均较术前改善(P<0.05),术后各时间点比较差异均无统计学意义(P>0.05);ODI评分术后2周、3个月及末次随访均较术前改善(P<0.05),术后各时间点比较差异均无统计学意义(P>0.05)。末次随访时,采用MacNab标准评定临床疗效:优16例,良2例,可2例,优良率为18/20。结论显微镜下通道技术高速磨钻骨面开窗摘除脱出髓核治疗腰椎间盘突出症,手术简便,患者恢复快,临床效果满意。Objective To investigate the clinical effect of microscope operation assisted with Quandrant channel technique in the treatment of lumbar disc herniation.Methods The 20 patients with single-segment lumbar disc herniation were treated with target puncture under minimally invasive Quadrant channel and fenestration removal of nucleus pulposus under microscope.At the pre-and post-operation,the VAS and ODI scores were used to evaluate the pain degree and function,respectively.The therapeutic effect was evaluated by MacNab criterion at the last follow-up.Results All patients were followed up for 6~18 months.There was no surgical complications and all incisions were healed in the first stage.The VAS were improved at postoperative 3 d,2 weeks,3 months and the last follow-up,compared with the preoperation(P<0.05),but there weren′t differences at the different time points(P>0.05).ODI scores were improved at postoperative 2 weeks,3 months after operation and the last follow-up,compared with the preoperation(P<0.05),and which had no statistical differences at the various time points(P>0.05).At the last follow-up,according to results of MacNab criteria evaluation:16 cases were excellent,2 cases good,and 2 cases fair,with an excellent and good rate of 18/20.Conclusions Under microscope assisted with the channel technique,high speed grinding and drilling the bone surface,fenestration removal of nucleus pulposus are used to treat the lumbar disc herniation,which is easy operation,fast recovery,with satisfactory clinical effect.

关 键 词：通道 显微镜技术 腰椎间突出症 

分 类 号：R681.53[医药卫生—骨科学] R687.3[医药卫生—外科学]