脊柱内窥镜下腰椎间盘摘除术远期疗效评价

Long-term result of endoscopic microdiscectomy for lumbar disc herniation

目的:评价脊柱内窥镜下腰椎间盘摘除术后的远期疗效.方法:对1995～1999年间行脊柱内窥镜下腰椎间盘摘除术治疗的156例腰椎间盘突出症患者进行信件问卷随访.分析患者的术后症状缓解、恢复工作情况.结果:共收到有效回信43封,随访率27.6%.临床疗效优良率81.4%,内窥镜组和开窗组疗效比较差异无显著性(P＞0.05).术后恢复工作时间平均为1个月,恢复原工种,占88.49%.影像学结果表明手术节段椎间隙无明显的高度下降或间隙失稳表现.结论:脊柱内窥镜下腰椎间盘摘除术是一种有效的治疗方法,应严格掌握手术适应证.

Objective:To evaluate the long term clinical result of endoscopic microdiscectomy for lumbar disc herniation.Method:A questionnaire following up was conducted in 156 patients who underwent endoscopic microdiscectomy for lumbar disc herniation during 1995～1999.Postoperative symptom alleviation,working ability of the patients were analyzed.Result:Forty three replied questionnaire letters were retrieved.The following up rate was 27.6%.The average follow up period were 6.7 years(5~8 years).There was no significant different between the “open window”group and endoscopic group( P >0.05).The time of returning to work was 1 month and the rate of returning to previous work were 88.49%.There was no height loss of involved discspace discovered,no segmental instability was found in the majority of the patients.Conclusion:Endoscopic microdiscectomy is a minimum invasive procedure,the successful clinical outcome could achieve in properly selected patients.Endoscopic microdiscectomy may achieve satisfactory long term result for treatment of lumbar disc herniation.Endoscopic microdiscectomy is a reliable and effective surgical procedure for the treatment of lumbar disc herniation.