微创工作通道治疗椎间盘突出症的临床疗效分析

Clinical analysis of lumbar disc herniation treated with minimally invasive system

[目的]评价直视下小切口术式治疗椎间盘突出症的可行性及有效性。[方法]本院自2004年3月～2010年9月采用开放式小切口术式治疗腰椎间盘突出症患者共445例。男性277例,女性168例;年龄22～58岁(平均46.7岁)。随访时间16～83个月(平均65.1个月),采用腰痛VAS评分及JOA评分。[结果]所有随访对象均无丢失,术前JOA(15分法)评分平均3.12分,末次随访JOA评分平均13.97分;术前VAS腰痛评分平均7.32分,末次随访腰痛VAS评分平均1.59分;术前腿痛VAS评分平均8.74,末次随访腿痛VAS评分平均1.12分;改善率为91.32%,优良率100%。[结论]实行小切口术式治疗腰椎间盘突出症取得了良好的疗效,此种手术方法创伤小,安全有效,可到达微创的效果,与现应用的椎间盘微创治疗技术并不冲突。

[Objective] To evaluate the feasibility and effectiveness of small incision surgery in the treatment of lumbar disc herniation （LDH） . [ Methods] From March 2004 to September 2010, 445 cases of LDH received the small incision surgery. There were 277 males and 168 females with an average age of 46. 7 years old. The follow - up were from 16 to 83 months. The VAS and JOA were adopted to evaluate the surgical effectiveness preoperatively and postoperatively. [ Results] All cases were followed up. Postoperative JOA （ 15 points method） score was 13.97 which had been significantly improved with the pre - operative score 3.12. Postoperative VAS score of pain of lumbar was 1.59 which had been significantly reduced compared with the pre - operative score 7.32. Postoperative VAS score of pain of leg was 1.12, pre - operative VAS score of pain of leg was 8.74. The execellent and good results rate were 100%. [ Conclusion] The small incision surgery can be feasibile and ef- fective in the treatment of LDH. The operative method is safe and effective, can reach the effect of minimally invasive surgery.