3种不同术式治疗腰椎间盘突出症的疗效分析

The comparative analysis of curative effectiveness of lumbar disc herniation treated with three different methods

目的评价3种不同术式治疗腰椎间盘突出症的临床疗效和适用范围。方法根据手术适应证对725例椎间盘突出症患者分别选择椎间盘镜下手术(179例)、小切口椎板间开窗(384例)、半椎板切除髓核摘除(162例)等术式治疗。结果725例均获随访,时间6～24个月,椎间盘镜组优良率(88.27%)及小切口椎板间开窗组优良率(90.89%)高于半椎板切除组(79.63%),差异有统计学意义(P<0.05)。椎间盘镜组优良率与小切口椎板间开窗组优良率差异无统计学意义(P>0.05)。结论严格掌握适应证,椎间盘镜下手术和小切口椎板间开窗术均为治疗腰椎间盘突出症较为理想的手术方式。

Objective To evaluate the effects of curative effectiveness of lumbar intervertebral disc herniation with three different methods.Methods 725 cases of lumbar intervertebral disc herniations were treated with three different methods,including microendoscopic discectomy （179 cases）,minimally invasive fenestration （384 cases）,and half laminectomy（162 cases） according to the operative indication.Results 725 cases had been followed up for 6 to 24 months. The curative effectiveness of microendoscopic discectomy（88.27%） and minimally invasive fenestration （90.89%）were better than that in half laminectomy group（79.63%）,（P〈0.05）. The curative effectiveness of microendoscopic discectomy was no significant different to minimally invasive fenestration （P〉0.05）.Conclusions With strict control of indications,both of microendoscopic discectomy and minimally invasive fenestration are effective to treat lumbar disk herniation.