双极射频热凝术与小切口椎间开窗髓核摘除治疗腰椎椎间盘突出症疗效分析

Curative effect analysis of bipolar radiofrequency thermocoagulation and discectomy by small incision fenestration for lumbar disc herniation

目的比较双极射频热凝术与小切口椎间开窗髓核摘除术治疗腰椎椎间盘突出症的临床疗效。方法 2006年3月～2008年6月,收治腰椎椎间盘突出症患者72例,随机分为小切口开窗组和双极射频热凝组。随访患者术后1个月、6个月及12个月的疗效评价。结果所有患者均未发生严重并发症,采用改良Macnab评价法评价疗效,双极射频热凝组术后1个月的优秀率、优良率均高于小切口开窗组,但差异无统计学意义(P>0.05);术后6个月、12个月优秀率、优良率与小切口开窗组相似,差异无统计学意义(P>0.05)。结论应用双极射频热凝术较小切口开窗髓核摘除治疗腰椎椎间盘突出症,创伤更小、康复更快,近期疗效满意、远期疗效可靠,是一种具有广阔发展前景的微创治疗术式。

Objective To compare the curative effect of bipolar radiofrequency thermocoagulation with discectomy by short incision fenestration in the treatment of lumbar disc herniation.Methods From March 2006 to June 2008,72 cases suffered lumbar disc herniation were divided into 2 groups randomly.One group were treated with bipolar radiofrequency thermocoagulation,the other group were treated with discectomy by small incision fenestration.Curative effect was evaluated at 1 month,6 months and 12 months postoperative.Results No severe complications occured during the follow up.Macnab＇s evaluating method was used to evaluate the curative effect.The excellent rate of bipolar radiofrequency thermocoagulation group was higher than small incision fenestration group at 1 month postoperative,but the difference was not statistically significant（P0.05）.Two groups got the similar excellent rate and good rate at 6 months and 12 months postoperative,and the difference was not statistically significant（P0.05）.Conclusion Bipolar radiofrequency thermocoagulation for the treatment of lumbar disc herniation can provide short-term satisfactory and long-term reliable efficacy,smaller trauma and faster recovery.It is hoped to be a kind of minimally invasive surgical treatment with broad prospects development.