椎间盘镜与开放手术治疗腰椎间盘突出症临床疗效分析

A comparative study of microendoscopie discectomy and open discectomy for lumbar dischermiation

目的比较后路椎间盘镜髓核摘除术(microendoscopic discectomy,MED)与开放椎板开窗(open discectomy,OD)治疗腰椎间盘突出症的临床效果及优缺点。方法回顾性分析手术治疗96例腰椎间盘突出症(椎间盘镜组、开放椎板开窗组各48例),分别比较两组手术时间、总出血量、黄韧带和椎板咬除量、住院时间、VAS评分;术后随访按Nakai评分统计术后优良率。结果椎间盘镜组和开放椎板开窗组术后优良率差异无统计学意义,两组在总出血量、黄韧带和椎板咬除量、术后住院时间差异有统计学意义,椎间盘镜组优于开放手术组。结论椎间盘镜与开放椎板开窗术均能缓解腰椎间盘突出症症状,但椎间盘镜具有切口小、组织损伤轻、恢复较快的优点。

Objective To compare the clinical therapeutic effects as well as advantages and disadvantages of microen-doscopic discectomy（ MED） and open discectomy （ OD） . Methods A restrospective study was carried out in a series of 96 patients （ 48 treated by MED and 48 by OD） treated from January 2006 to January 2009. The operation time,the total amount of bleeding,the quantity of yellow ligament biteand lamina bite and duration of hospitalization after operation and VAS were compared. The rate of excellent and good outcomes were evaluated according to Nakai criterian. Results Significant difference was found between MED group and OD group in bleeding,the quantity of yellow ligament biteand lamina bite and duration of hospital after operation. Conclusion Compared with the OD,MED has advantages such as smaller incision,mild damage of tissues,bleeding less,quicker recovery. By both methods,the clinical outcomes are similar in the treatment to relieve the symptoms of the lumbar dischemiation.