改良微创Love手术治疗腰椎间盘突出症的远期疗效分析

The long-term evaluation of treatment for the lumbar disc herniation with the modified Love operation

目的探讨改良微创Love手术治疗腰椎间盘突出症的远期疗效。方法1995年1月至2000年12月共373例腰椎间盘突出症患者接受改良微创Love手术治疗，其中男性250例，女性123例，年龄11～77岁，平均年龄45．0岁。所有患者均以坐骨神经痛为主诉，部分伴有腰痛。病变部位：L3,411例，L4,5 159例，L5-S1 195例，L4,5及L5-S1同时病变8例。结果平均手术时间65min，平均术中出血量22ml，手术切口平均长3．2cm。截至2005年9月，317例患者获得随访，随访率85．0％；随访时间5年6个月～10年5个月，平均7年8个月。135例患者接受椎间盘造影检查，按照改良的Roland-Morris功能障碍评分系统：优198例，良68例，中51例，优良率84．0％。10例（3．2％）手术椎间盘突出复发；其中7例接受内固定术，1例选择保守治疗。1例出现腰椎滑脱。结论改良微创Love术远期疗效肯定，可作为腰椎间盘突出症手术治疗的首选方法。

Objective To explore the long-term outcome of lumbar disc herniation （LDH） after the treatment with modified mini-invasive Love operation. Methods From January 1995 to December 2000, 373 patients suffered from LDH underwent the modified mini-invasive Love operation. There were 250 male and 123 female patients aged from 11 to 77 years old （with a mean of 45.0 years old）. Most patients complained of sciatica accompanying back pain. The lesion level included L3,4 in 11 patients, L4,5 in 159 patients, L5-S1 in 195 patients and L4,5 combined with L5-S1 in 8 patients. Results The average operative duration was 65 min. The average blood lose was 22 ml. The average incision length was 3.2 cm. Till September 2005, 317 patients were available at the final follow-up during the period from 5 years and a half to 10 years and 5 months. The average duration of follow-up was 7 years and 8 months. A total of 135 patients underwent the CT discogram. According to the modified Roland-Morris Dysfunction Questionnaire, 198 patients were rated as excellent, 68 as good, and 51 as fair. The excellent rate was 84. 0%. The scores for young patients were higher than senile patients. Herniation recurrence occurred in 10 patients （ 3.2% ）, in which 7 patients underwent the operation of internal fixation and 1 patient preferred the conservative treatment. One patient got the spendylolisthesis. Conclusions The long-term outcome of the modified mini-invasive Love operation is effective. It is a good choice for the LDH patients.