经皮穿刺腰椎间盘切吸术治疗腰椎间盘突出症的远期疗效

Remote-term efficacy of percutaneous lumbar diskectomy for treating lumbar disc herniation

目的观察X线电视引导下经皮穿刺腰椎间盘切吸术治疗腰椎间盘突出症的远期疗效。方法32例经CT扫描证实的腰椎间盘突出症患者,其中,膨出型29例,游离型2例,以及突出型1例,均经X线电视引导下经皮穿刺腰椎间盘切吸术治疗,术后均经随访0.5～11.0a。结果术后1周～3个月,32例中的24例临床症状与体征得到有效控制或明显减轻,随访5～11a观察表明,症状完全消失和明显减轻者分别见于23例和6例,总有效率90.6%,预后极好和较好者均见于膨出型腰椎间盘突出症患者。结论游离型和突出型腰椎间盘突出症的疗效均不理想,因此,术前认真选择适应证是获得理想疗效的关键性因素。

Objective To observe the remote - term efficacy of percutaneous lumbar diskectomy（PLD） for treating lumbar disc herniation（LDH）. Methods Thirty - two patients with LDH confirmed by CT scans, which comprised bulging pattern（ n = 29）, free pattern（ n = 2） and herniated pattern（ n = 1 ） underwent the treatment of PLD under X -ray television guidance. All patients were followed - up 0. 5 to 11.0 years after the operation. Results At one week to three months after the operation, the main symptoms and signs in 24 of 32 patients were controlled effectively or relieved markedly. At 5 - 11 years after the operation follow - up showed that the complete disappearance and obvious relief of clinical symptoms were found in 23 and 6 cases, respectively, the total efficient rate was 90. 6%. The patients having best or better prognosis were found in those with bulging pattern LDH. Conclusion In the patients with free or herniated patten LDH, the efficacy of PLD is unsatisfactory so that preoperatively careful selection of the indication is a key factor to acquire the satisfactory efficacy.