椎间盘镜手术与开窗术治疗腰椎间盘突出症的临床分析

Clinical analysis of microendoscopic discectomy and vertebral lamia fenestration in treating lumbar disc herniation.

目的对照椎间盘镜手术(MED)与开窗手术治疗腰椎间盘突出症的临床效果。方法对腰椎间盘突出症61例患者采用椎板开窗髓核摘除术,对54例患者采用MED,比较手术的时间、切口大小、术中出血量、卧床时间及手术效果。结果MED组优良率为90.7%,开窗术组优良率为88.5%,统计学上差异无显著性。而手术时间[(41±4)min、(74±8)min]、切口大小[(1.6±0.0)cm、(10.8±0.8)cm]、术中出血量[(38±6)ml、(207±40)ml]和卧床时间[(12±5)d、(25±9)d]比较差异有显著性。结论MED治疗腰椎间盘突出症的效果与开窗术相同,但该手术具有创伤小、出血少、术后恢复快、不影响腰椎稳定性等优点,是治疗腰椎间盘突出症的有效方法之一。

Objective To compare the curative effect of microendoseopie discectomy （ MED ） and vertebral lamia fenestration in treating lumbar disc herniation. Methods 61 patients with lumbar disc herniation underwent removal of nucleus pulposus with vertebral lamia fenestration and other 54 cases were treated with MED. The differences of operative time, incision size, blood loss, bed rest time and clinical effect were compared. Results The excellent rate was 90.7% in MED group and 88.5% in vertebral lamia fenestration group ruth no significantly statistical difference between two groups. But the operative time [ （ 41 ＋ 4 ） rain vs （ 74 ＋ 8 ） min ], length of incision [ （ 1.6 ＋ 0.0 ） cm vs （ 10.8 ＋ 0.8 ） cm ], blood loss [ （ 38 ＋ 6 ） ml vs （ 207 ＋ 40 ） ml ] and bed rest time [ （ 12 ＋ 5 ） d vs （25 ＋9）d] were of significant difference in the two groups. Conclusion The clinical results of microendoscopie discectomy and vertebral lamia fenestration are nearly the same,but microendoscopie diseectomy has some advantages such as minimal invasion,less bleeding, and faster recovery. It is effective in the treatment of lumbar disc herniation.