经皮腰椎间盘切吸术治疗腰椎间盘突出症的临床观察

Analysis of the treatment of lumbar disc herniation with automated percutanous lumbar discectomy

目的探讨经皮腰椎间盘切吸术(automated percutaneous lumbar discectomy,APLD)治疗腰椎间盘突出症的疗效并对影响疗效的相关因素进行分析。方法 226例腰椎间盘突出经APLD治疗后,观察术后疗效和分析术后恢复时间、椎间盘突出类型、切吸量以及术后处理等相关因素对术后疗效的影响。结果经平均2.8年随访,治疗有效率为94.1%(212/226),其中术后2～4周治疗有效率达到77.83%(165/212);切吸量>2g的治疗有效率为98.5%(205/208);中央性局限性突出的有效率为99.1%(118/119)。结论 APLD是一种治疗腰椎间盘突出症疗效肯定且简单有效的方法。术后2～4周为恢复最佳时期;后正中突出并良好的后纵韧带为最佳适应证;术后适时、适度牵引治疗有助于APLD疗效的提高。

Objective To investigate therapeutic effect and the related factors of treating lumbar disc herniation with automated percutanous lumbar discectomy（APLD）.Methods Using APLD 226 patients suffering from the disease were treated after they were checked by axial tractions straight leg raising test（ATSLRT）.The therapeutic effect should been observed and the correlation of the therapuetic effect with the factors such as the time of healing,the choice of candidates,the amount of disc tissue removed and the dealing of the postoperative had been analyzed.Results With 2.8 years followed up,the good treatment rate was 94.1%,specially that was 77.83% between 2～4 weeks;the rate was 98.5% when the amount of the removed disc tissue exceeded the weight of 2g,the efficiency rate was 99.1% when it was the kind of middle herniation.Conclusion The APLD is a good method for the treatment of lumbar disc herniation.It is the gold time between 2～4 weeks for the patients recovery;The middle herniation with good posterior longitudinal ligament should be the best choice and the corresponding dealing for the post-operation should be necessary.