后路椎间盘镜下治疗腰椎间盘突出并椎体后缘离断症的疗效观察

Effect Observation of Posterior Microendoscopic Discectomy for the Treatment of Lumbar Intervertebral Disc Herniation Complicated with Posterior Element Distraction

目的探讨后路椎间盘镜下治疗腰椎间盘突出并椎体后缘离断症的临床疗效。方法对34例腰椎间盘突出症合并椎体后缘离断症患者,采取经后路椎间盘镜下进行手术治疗,根据改良Macnab疗效评定标准进行疗效评定,采用JOA评分方法对患者术前、术后症状评分,并对术前、术后评分结果进行分析。结果根据改良的Macnab疗效评定标准,优23例(67.65%),良9例(26.47%),可2例(5.88%),手术后优良率为94.12%。JOA评分法的改善率为81.11%(P<0.05),无并发症发生。结论对于严格选择的腰椎间盘突出并椎体后缘离断症的患者,实行后路椎间盘镜下治疗,术后可获得较高的优良率和改善率,疗效肯定。

Objective To explore the clinical efficacy of posterior microendoscopic discectomy in the treatment of lumbar intervertebral disc herniation complicated with posterior element distraction. Methods 34 cases with lumbar inter- vertebral disc herniation complicated with posterior element distraction were treated with posterior microendoscopic discecto- my in surgery. The efficacy was evaluated according to the improved Macnab criteria. Symptoms in pre - and post - surgery were scored by JOA method and the results were analyzed. Results According to the improved Macnab criteria, regarding efficacy, it was classified as excellent in 23 cases （67. 65% ） , good in 9 cases （26. 47% ）, and fair in 2 cases （5.88%）. The excellent and good rate was 94. 12% after surgery. Following JOA methods, the improvement rate was 81.11% （P 〈 0. 05）, and no complications occurred. Conclusion For those strictly selected patients with lumbar intervertebral disc herniation complicated with posterior element distraction, a higher excellent and good rate as well as improvement rate can be obtained after being treated by posterior microendoscopie diseectomy, and the curative efficacy was definite.