椎间盘镜术与传统椎板间隙开窗术治疗青少年腰椎间盘突出症的比较研究

Comparison of operative result of MED with conventional discectonomy in treating lumbar disc herniation in the adolescents

[目的]比较显微内窥镜腰椎间盘切除系统(microendoscopy discectomy,MED)与传统的后路椎板间隙开窗术治疗青少年腰椎间盘突出症的疗效。[方法]回顾分析130例青少年腰椎间盘突出症患者的临床资料,观察组为椎间盘镜术(MED)组64例,对照组为后路椎板间隙开窗术组66例,根据Nakai标准评价疗效,并观察两组手术时间、术中出血量、术后镇痛药物应用、术后下床活动时间、术后住院日及恢复正常生活或工作的时间情况。[结果]经术后6个月～11年的随访,椎间盘镜术(MED)组优良率为93.5%,后路椎板间隙开窗术组优良率90.6%,两组疗效比较,差异无显著性(P>0.05),但MED组在术中出血量、术后镇痛药物的应用、术后下床活动时间、术后住院时间、恢复正常生活或工作时间优于后路椎板间隙开窗术组(P﹤0.05)。[结论]椎间盘镜术(MED)治疗青少年型腰椎间盘突出症疗效与后路椎板间隙开窗术相同,但椎间盘镜术(MED)具有创伤小、对腰椎稳定性破坏小、出血少、住院时间短、术后恢复快等优点,是治疗青少年腰椎间盘突出症的一种理想手术方法。

[ Objective] To compare the clinical results of microendoscopy discectomy with conventional discectomy in trea- ting lumbar vertebral disc herniation in the adolscents. [ Methods] With the methods of retrospective study the clinical statis- tics, 130 adolescent patients with lumbar disc herniation were randomly divided into two groups, 64 patients were the group of observation with MED and 66 patients were the controlled group with conventional discectomy. We evaluated the results by themethod of NakaiIlj , and also by 6 factors, including operative time, the blood loss, whether to have anodyne, the time out of bed, postoperative hospital stay time and the time of return to previous sport level. [ Results ~ All cases were h^llowed up tbr 6 months - 11 years, the improvement of MED scores were 93.5% , compared with 90. 6% in control group. But there was sig- nificant difference in statistics about the 6 factors between the two groups. [ Conclusion ] The clinical results ware nearly the same with two methods. But compared with conventional discectomy, MED can reduce trauma to the tissue, the blood loss in operative, operation time , anodyne using, the time out of bed after operation, the post - operative hospital stay time and the time of return to previous sport, and shows more stability to the spinal vertebrae. The MED operative system to treat adolescents patient is an ideal surgical operatve method.