腰椎间盘切除不同术式临床应用比较

A compartison study of clinical application of lumbar discectomy with different method

目的比较显微腰椎间盘切除术、传统腰椎间盘切除术和椎间盘镜下腰椎间盘切除术治疗单节段腰椎间盘突出症的临床效果。方法对3种不同方法手术治疗的84例单节段腰椎间盘突出症患者临床效果进行分析,其中显微腰椎间盘切除术(Microsurgical lumbar discectomy,MSLD)31例,传统腰椎间盘切除(Conventional open lami-notomy and discectomy,COLD)29例,椎间盘镜腰椎间盘切除术(Microendoscopic discectomy,MED)24例。比较3种治疗方法的手术情况和术后疗效。结果MSLD与MED组较COLD组手术切口小,出血少,卧床和住院时间短,并发症少,MED组有1例复发而再次手术治愈。术后优良率MSLD与MED组高于COLD组,统计学上有显著性差异,但MSLD与MED组之间无显著性差别。结论MSLD与MED手术创伤小,术后恢复快,术后并发症少,两者疗效相当,但均优于传统腰椎间盘切除术。

Objective To compare therapeutic effect of the microdiscectomy, conventional open laminotomy and discectomy and microendoscopic discectomy for lumbar disc herniation. Methods To study clinical results of three different kinds of methods for 84 cases of a single lumbar disc herniation. Microsurgical lumbar discectomy （ MSLD）, conventional open laminotomy and discectomy （ COLD）, microendoscopic discectomy for lumbar discectomy （MED） respectively were performed in 31 , 29 and 24 cases. Results The average length of the incision in MSLD and MED groups was shorter than in COLD group, it was less bleeding, shorter bedridden and hospitalization and fewer complications in MSLD and MED groups than in COLD group. One case in MED group recurrented and reoperation was performed with COLD. Excellent and good rate of the MED and MSLD was higher than COLD, it was significant difference statistically, but between MED and MSLD was not significant difference statistically. Conclusion MSLD and MED were less surgical trauma and rapid postoperative recovery, less postoperative complications than COLD, the effect is both, but it was therapeutic equivalence between the MED and MSLD.