小切口椎板开窗治疗腰椎间盘突出症32例

Vertebral lamina fenestration with small incision for the treatment of 32 cases of lumbar disc hernation

目的探讨小切口椎板开窗治疗腰椎间盘突出症(LDH)的疗效.方法将71例单侧、单节段单纯的LDH患者随机分成A、B两组.A组采用小切口椎板开窗,B组采用标准的全椎板切除或扩大椎板切除.所有病例随访1～3年,平均2.5年.结果A组优19例,良5例,中4例,差4例,总有效率87.5%.B组优13例,良9例,中9例,差8例,总有效率79.5%.两组比较差异有显著性(P＜0.05).两组中以腿痛为主要症状接受手术治疗者疗效优于同组中以腰、腿痛为症状者.结论小切口椎板开窗治疗LDH手术创伤小,效果好.

Objective To explore the effect of vertebral lamina fenestration with small incision for the treatment of lumbar disc hemation（LDH）. Methods Seventy-one patients with lateral andd simple segment lumbar disc hemation were randomly divided into group A and group B. The operation with small incision in 32 LDH patients was performed in group A. Standard total laminectomy and enlarged laminectomy in group B of 39 LDH patients were performed. All cases were followed up for 1- 3 years （mean 2.5 years）. Results Assessed by the JOA criteria, 19 cases were rated as excellent, 5 cases as good, 4 cases as fair and 4 cases as poor,total effective rate was 87.5% in group A. In group B 13 cases were rated as excellent,9 cases as good, 9 cases as fair and 8 cases as poor, total effective rate was 79.5 %. There was significant difference in two groups（ P 〈 0.05 ）. Efficacy in patients with predominant skelalgia was better than that in patients showing lumbocrural pain. Conclusion The vertebral lamina fenestration with small incision for LDH patients with small trauma and is effective.