前、后入路腰间盘摘除术远期疗效对比分析

A Comparative Analysis of Long_term Follow_up Outcome of Anterior, Posterior Approach Discectomy

目的：对比分析前、后入路腰椎间盘摘除术远期疗效，为临床腰椎间盘摘除术术式选择提供一定的理论基础。方法：应用Ｒｏｌａｎｄ，Ｇｒｅｅｎｏｕｇｈ标准及疗效评定相关指标随访１９８４～１９９１年底间于我院行首次腰椎间盘摘除术的患者。有效随访前路６７例，后路１３６例，随访时间３～１１年。应用ＦｏｘＢＡＳＥ＋２．１０建立数据库，ＰＣＳＡＳ６．０３进行各种统计分析。结果：前路手术有手术时间短，术中出血少，术中并发症少，术后恢复快的优点，其远期疗效亦稍优于后路组。按病程及年龄分层分析结果显示它们对术后疗效无显著影响。结论：对有手术指征而无前路手术禁忌证的患者，特别是术后要求从事体力劳动者，前路手术是较好的选择。

Objectives: To comparatively analyze the long_term outcome of anterior and posterior approach discectomy and provide a the thoretical basis for the clinics application. Methods: The Roland and Greenough rating system and a few relative items were used to analyse the patients who undergone first discectomy in our hospital between 1984 and 1991. Of these, anterior approach was used in 67 cases, posterior in 136. The follow_up period was 3 to 11 years. Results: It showed that the anterior approach discectomy had the shorter operative time, less bleeding,less opterative complication and faster recoverage. The long term result of anterior approach was also better than that of posterior. The analysis by illness duration and age showed that there were no significant effect on the results. Conclusions: The authors point out that for the patients who have the indication of discectomy, especially for those labor worker, the anterior approach disectomy is a better choice.