显微镜下微创治疗腰椎间盘突出症

Treatment of the lumbar disc herniation by minimally invasive microscopy surgery

目的:探讨显微镜下微创治疗腰椎间盘突出症(LDH)的手术注意事项和疗效。方法:记录76例LDH患者临床表现、MRI特点,所有患者均行后路显微镜下微创间盘取出术,采用数字疼痛评分(NRC)和Oswestry量表(ODI)评估患者疼痛和生活质量变化情况。结果:76例患者均获随访,时间3～14月(平均8个月),平均手术时间分别为(1±0.2)h;出血(50±20)ml。患者术前NRC腰痛评分、NRC腿痛和ODI评分评分分别为:(7.25±1.43)、(7.47±2.05)、(53.24±5.49),术后3月时分别为(3.24±1.25)、(3.34±1.86)、(75.69±8.24),均得到显著改善,术前和术后3月随访时评分之间差异有显著性(t检验,P<0.05)。76例患者手术满意程度:优50例,良22例,可4例,差0例。结论:腰椎后路显微镜下微创治疗LDH一般可获得满意疗效,手术时注意保护神经根,清晰的术野是手术成功的关键。

Objective： To evaluate the effeciency of surgical treatment of lumbar disc herniation by minimally invasive microscopy surgery. Methods： 76 patients with lumbar disc sequestration were treated. Before operation, the duration, symptoms and MRI characters were recorded. All the patients were operated by posterior minimally invasive microscopy surgery. The Numeric Rating Scale （NRC） and Oswestry Disability Index （ODI）were used to evaluate the pain relief and living quality change. Results：The patients were followed from 3 to 14 months. The surgery time was （1±0.2） hour and the bleeding was （50±20） ml. The preoperation NRC pain of lumbar and thumb, and ODI score were （7.25±1.43 ）, （7.47±2.05）, （53.24±5.49） respectively; 3 months post-operation the score changed into （3.24±1.25）, （3.34±1.86）, （75.69±8.24） respectively. There was statistical significance between post and pre operation （P〈0.05）. Excellent and good results were obtained in 72 cases. Conclusion： It is an effective method to treat lumbar disc herniation by minimally invasive microscopy, the key points are to keep a clear surgery field and protect the neural tissue.