双侧与单侧穿刺等离子消融髓核成形术治疗腰椎间盘突出症的中期疗效观察

Observation of medium-term therapy of bilateral and unilateral lunmbar puncture plasma coblatiom nucleoplasty in treatment of lumbar disc herniation

目的 比较双侧穿刺与单侧穿刺等离子刀消融髓核成形术治疗腰椎间盘突出症的中期疗效.方法 经CT或MRI确诊为包容性突出、纤维环未见明显破裂的轻中度腰椎间盘突出症患者90例,按随机数字表法分为两组,每组各45例.分别采用双侧穿刺（A组）与单侧穿刺（B组）等离子刀汽化髓核成形术治疗.比较两组患者术后随访时腰椎JOA评分.结果 两组共82例获得随访,随访时间10～32个月,平均16.2个月.术前两组患者JOA评分差异无统计学意义（P＞0.05）.术后A组及B组JOA评分分别为（25.02±2.93）分和（23.15±3.11）分,均明显高于术前（t=24.014,18.251,均P=0.000）.术后随访时A组评分高于B组（t=2.649,P=0.006）.结论 双侧穿刺等离子刀消融髓核成形术治疗腰椎间盘突出症的中期疗效优于单侧穿刺.

Objective To compare medium-term therapeutic effect by bilateral and unilateral puncture plasma coblation nucleoplasty（PCN） in the lumbar disc herniation patients. Methods 90 cases confirmed no significant rupture of annulus fibrosus of lumbar disc herniation by CT or MRI were randomly divided into two groups. Bilateral and unilateral puncture plasma coblation nucleoplasty groups were respectively divided into group A and group B, and compared the JOA scores. Results 82 patients were followed up for 10 ～ 32 months,the average follow-up time was 16.2 months. Preoperative JOA scores of the two groups were not statistically significant（P ＞ 0.05） but the postoperative follow-up JOA scores were higher than preoperative（P ＜0.05） and the JOA scores of group A were higher than group B（P ＜0.05）. Conclusion The medium-term therapeutic efficacy of bilateral puncture coblation nucleoplasty was superior to unilateral therpy.