MED腰椎单节段髓核摘除术中期疗效评价

Middle-term Efficacy of Microendoscopic Discectomy(MED) for Lumbar Intervertebral Disc Herniation

目的评价腰椎间盘突出症患者行MED髓核摘除术后的中期疗效。方法对2004-2006年在我科行MED腰椎单节段髓核摘除术治疗420例患者进行随访,随访时间3 5年,平均4.2年。结果①术后3月内恢复工作者406例(96.7%)。②患者自觉症状消失达满意程度者412例(98%)。③全部病例的施术腰椎间隙高度术后均有不同程度的丢失,术后4年平均丢失13%,暂未发现局部不稳。结论①MED腰椎单节段髓核摘除术治疗腰椎间盘突出症中期随访效果优良。②本组MED髓核摘除术后随访结果显示术后椎间隙变窄者均未发现腰腿痛等症状复发。③MED髓核摘除术是治疗单节段腰椎间盘突出症的可靠而有效的微创方法。

Objective To investigate the middle - term efficacy of microendoscopic discectomy （MED） for lumbar intervertebral disc herniation. Methods A retrospective analysis was made on 420 eases of lumbar intervertebral disc protrusion treated by microendoscopic discectomy with the follow-up tinie ranging from 3 to 5years （ 4. 2 years averagely）. Results Among the 420 cases, 406 （96. 7% ） were back to work in 3 months after the operation; 412 （98%） cases were satisfied with the disappearance of symptoms; all cases suffered loss of the operated lumbar intervertebral height in different degree （the average loss of 13% at 4 years after the surgery） without the local instability. Conclusion （1） MED single segment lumbar discectomy for lumbar disc herniation had excellent middle-term follow-up results. （2）Follow-up results of MED discectomy in this group showed that there were no recurrence of low back pain and other symptoms with postoperative intervertebral space narrowing. （3）MED discectomy is an effective and reliable minimally invasive method to treat single segments of the lumbar disc herniation.