有限髓核摘除加同侧侧隐窝扩大术治疗中老年腰椎间盘突出症的疗效观察

The clinical results of limited nucleus pulposus excision adds with the same side recessus expansion techniquein the treatment of lumbar disc herniation

目的:探讨腰椎间盘突出症患者有限髓核摘除加同侧侧隐窝扩大术的临床治疗效果。方法:对我院自2002年～2007年收治的经严格保守治疗后反复发作,动力位腰椎片无腰椎不稳采用椎板开骨窗行变性椎间盘组织摘除加同侧侧隐窝扩大术的69例病例进行回顾性分析。术后严格卧床3周,术后第1天进行双下肢直腿抬高,1周后进行腰背肌功能训练。结果:69例病例均得到有效随访,随访期限为1.5～5年,61例病例术后腰腿痛症状无复发,7例症状明显缓解,有轻微的腰痛,69例均无下肢症状,1例术后1年同间隙复发再手术行扩大椎板窗口行髓核摘除术,术后症状缓解;术后根据JOA评分标准,优良率达89.21%。结论:把握手术指征,该术式不失为中老年腰椎间盘突出患者可靠的治疗手段之一,具有明显临床效果,而且5年期内效果也满意。

Objective： To investigate clinical results of limited nucleus pulposus excision adds with the same side recessus expansion technique in the treatment of lumbar disc herniation. Methods ： To my hospital from 2002 - 2007 admitting manifested repeatedly after the strict conservative treatment, the power position lumbar vertebra piece didnt have the lumbar vertebra to use the board to open the bone window good denatured intervertebral disc organization not steadily to excise adds carries on the review analysis with side recessus expansion technique 69 example cases. After operation; being strictly confined to bed for 3 weeks, the first day with the double lower limbs straight leg to raise, after a week carrying on the lumbodorsal region myo -function training. Results ：69 example case of illness obtain the effective revisit, the revisit deadline is 1.5 - 5 years, 61example case of illness technique the pain in waist and lower extremities symptom does not have the recrudescence, 7 example symptom obvious alleviation, with slight lumbago, 69 example with non-lower limb symptom. One year later, 1 patient with space for recurrent surgery with extended laminar window line diseectomy, postoperative symptoms were relieved after the technique acts according to the JOA grading standard, fine rate reaches 89.21%. Conclusion：This type of surgery is reliable for middle and old aged waist intervertebral disc prominent patients. It has tangible clinical effect.