腰椎间盘突出症手术疗效的临床观察

Clinical observation of surgical outcomes of lumbar discectomy

目的 探讨腰椎间盘突出症术后疗效预测因素及术后疗效变化特点。方法 选择本院1985-2003年腰椎 间盘突出症手术病例共204例,采用问卷调查方式,通过电话、信函及门诊随访完成疗效评分资料的收集。将随访病例分 为4组:术后1～2年组、术后2～4年组、术后4～8年组及术后8年以上组,采用多元回归分析法对各组进行疗效相关因 素分析,并组间比较以分析疗效变化特点。结果 腰椎间盘髓核摘除术后疗效与年龄、性别、腱反射改变、术前肌力有无 改变、直腿抬高试验角度、职业、外伤史、文化程度、手术方式(全或半椎板切除、椎板间开窗法,术中小关节切除小于1/3)、 手术节段数、有无侧隐窝狭窄、采用椎间盘镜或传统手术方式等情况无相关性,与术前症状持续时间相关。根据Prolo标 准评分,术后1～2年、术后2～4年、术后4～8年及术后8年以上等各时段疗效无统计学显著性差异。结论 腰椎间盘突 出症手术疗效与术前症状出现时间相关,其术后疗效在手术2年以后呈现出相对稳定的特点。

Objective To investigate the predictors and characteristics of the surgical outcomes of lumbar discectomy. Methods A total of 204 patients undergoing lumbar discectomy in our hospital from 1985-2003 were selected. The data on the surgical outcomes were collected using questionnaire, communication, and clinical follow-up. The cases were divided into four groups according to the different postoperative time: 1-2, 2-4, 4-8 years, and more than 8 years. The correlated factors in surgical outcomes in the four groups were analyzed by multiple regression analysis. The predictors and characteristics of the surgical outcomes in the four groups were compared. Results The duration between symptom onset and operation was significantly associated with the surgical outcomes. There was no statistical difference in surgical outcomes between the four groups. Conclusion The surgical outcomes of lumbar discectomy are closely associated with the preoperative onset of symptoms and remain unchanged in 2 years after operation.