小切口椎板间开窗术治疗腰椎间盘突出症

Treatment of Lumbar Disc Herniation by Interlaminal Windowing with Small Incision

目的:总结小切口椎板间开窗髓核摘除术治疗腰椎间盘突出症的临床特点和疗效。方法:131例腰椎间盘突出症患者采用后正中入路、椎板间开窗髓核摘除术,应用日本JOA标准进行疗效评价。结果:随访10个月-7年,术前JOA评分平均为8.5分,术后平均为27.8分,术后改善率为94.2%。无椎间隙塌陷和椎间失稳现象。结论:术前认真查体、读片,严格把握手术指征,术中规范操作、彻底摘除髓核,进行椎板间开窗髓核摘除术治疗腰椎间盘突出症具有创伤小、对脊柱稳定性结构破坏小等优点,可取得满意的疗效。

Objective： To summarize the clinical feature and curative effect in the treatment of lumbar disc herniation by interlaminal windowing with small incision. Method： 131 cases with the protrusion of lumbar intervertebral disc were treated with operation of interlaminal windowing with small incision, and JOA standard was introduced for the evaluation of the clinical curative effect. Results：All cases were followed up from 10 months to 7 years. The preoperative mean JOA score was 8. 5 points and the postoperative one was 27.8 points, and the postoperative improvement rate was 94. 2 %. There were no phenomenon of intervertebral space collapse and intervertebral distabilization. Conelusion： The operative method of small incision technique might gain satisfying results if physical examination and film reading before operation is performed carefully, operative index is commanded strickly, standard operation procedure is complied, nucleus pulposus is excised thoroughly, and the technique has the advantage of less trauma and minimal damage to spinal structure.