小切口小开窗治疗腰椎间盘突出症临床研究

Clinical research for Treatment of lumbar disc herniation by mini-incision and mini-open-windows

目的探讨治疗腰椎间盘突出症有效的手术方法并总结其优点。方法对108例腰椎间盘突出症患者行病变椎间后路正中4-5cm长小切口,显露一侧椎板,在相邻椎板间隙开一直径约1.5cm×1.5cm小窗,摘除间盘髓核。并与传统全椎板切除手术方法进行比较。结果随访3个月-7年9个月,平均3年10个月。用侯树勋[1]评定标准进行评定,开窗组优良率为93.5%,明显高于传统手术组(59.1%)(P<0.01)。结论小切口小开窗手术方法治疗腰间盘突出症,具有手术简便、创伤小、出血少、住院时间短、费用低、短期内可恢复原工作等优点。

Objective To discuss an effective treatment method for lumbar disc herniation. Methods 108 cases of lumbar disc herniation underwent a posterior focal interspinal central mini - incision about 4 - 5cm. Opening a mini - window about 1.5crn × 1.5cm in the interstice between the closed lamina arcos vertebrae after appearing one - side lamina arcos vertebrae. Then, removing the vertebral pulp and comparing with the traditional total laminectory or hemi laminectory. Results All patients were followed up frcrn 3 months to 7years and 9 montths with an average of 3 years and 10 months. Evaluating the new method with the standard of Hou Shuxun. The satisfactory rate, which is 93.5 % in mini - open - windows group, was higher than that in trad - itional group which is 59.1% （ P 〈 0.01 ）. Conclusion The treatment for lumbar disc herniation by mini - incision and mini - open - windows has the advantages of simple operation, light wound, lower bacmorrhage , shorter hospitalization time,lower expense, more rapid recovery in a short term.