手术治疗老年性腰椎间盘突出症68例临床分析

Surgical treatment for 68 elderly patients with lumbar disc herniation

目的:探讨老年性腰椎间盘突出症的临床特点、手术方式、疗效及疗效影响因素。方法:回顾性分析2009年1月～2010年1月就诊于我科并接受手术治疗的老年性腰椎间盘突出症68例,观察其临床特点、手术方式、疗效及疗效影响因素。结果:68例患者均进行手术治疗,24例采用后路锥板开窗髓核摘除术;21例采用经皮内镜下椎间盘切除术;23例采用经皮穿刺腰椎间盘摘除术。疗效为优者36例,良者21例,可9例,差2例,总优良率为83.8%。后路锥板开窗髓核摘除术治疗优良率较后两者高(P<0.05)。手术方式、血肿压迫、术后感染可能是影响手术疗效的重要因素。结论:采用手术治疗老年性腰椎间盘突出症安全、有效,能够显著改善患者生活质量。

Objective： To investigate the clinical features of lumbar disc herniation in elderly patients,curative effects of different surgical treatments as well as related factors.Methods：Retrospective analyses on 68 elderly patients with lumbar disc herniation that were admitted to our hospital during January 2009-January 2010 and underwent surgery were conducted.And the clinical features,curative effects of different surgical treatments as well as related factors were analyzed.Results： Of the 68 patients,24 patients underwent surgery of nucleus pulposus removal from the posterior region;21 cases had percutaneous endoscopic lumbardiscectomy;23 cases were treated with percutaneous lumbar discectomy.Efficacy was excellent in 36 cases,good in 21 cases,ok in 9 cases,and poor in 2 cases showing an total excellent and good rate of 83.8%.Nucleus pulposus removal from the posterior region showed higher efficacy than the latter two methods（P〈0.05）.Surgical approaches,hematoma compression,postoperative infection may be important factors affecting the surgical effects.Conclusions： As a safe,effective treatment,surgery can improve patients’ life quality.