有限化手术治疗原位复发性腰椎间盘突出症42例

Finite surgery for treatment of recurrent lumbar disc herniation in situ

目的:探讨有限化手术治疗原位复发性腰椎间盘突出症的方法及效果。方法:对2002年2月至2006年3月收治的42例因原位复发性腰椎间盘突出症行有限化手术治疗的患者资料进行回顾性分析,采用JOA评分(15分)及影像学检查评价治疗效果。结果:本组共42例,经1～5年,平均2.5年随访,无脊柱失稳表现。根据JOA评分标准,术前平均(6.2±2.3)分,术后3个月随访时平均(13.6±3.4)分,经统计学检验手术前后JOA评分差异有显著性(P<0.05),JOA评分临床改善率为85.07%,患者主观满意度优良率为87.20%。5例患者术中硬脊膜撕裂,经处理无重大并发症。结论:有限化手术治疗原位复发性腰椎间盘突出症安全可行,能有效解除神经压迫,有利于脊柱稳定,创伤小,患者术后恢复快。

Objective To explore the method and clinical outcome of finite surgery of recurrent lumbar disc herniation in situ. Methods From Febrary 2002 to March 2006, 42 cases with recurrent lumbar disc herniation in situ which were treated surgically with finite surgical treatment were reviewed retrospectively. The results were evaluated with Japanese Orthopedic Association score （JOA, 15 scores）, patients＇ subjective satisfaction degree, complications and radiographic findings were also reviewed. Results All cases were followed for an average period of 30 months and none presented spinal disablement. According to JOA score, the everage before surgery was （6.2 ± 2.3 ） and after 3 months was （13.6 ± 3.4）. There was significant increase of JOA score in the 3-month follow-up （P 〈 0.05 ）. 87.20% of patients were satisfied with their clinical outcome. Complications included dural tear in 5cases. Conclusions Finite surgical treatment for recurrent lumbar herniation is available and safe. It can relieve spinal canal decompression efficiently and sustain segmental stability.