保留黄韧带椎板切除术预防硬膜粘连的临床分析

The clinical study of retain ligamentum flavum in preventing the dur adhesive in the epidural after lumbar disctomy

目的探讨保留黄韧带预防硬膜外粘连的疗效。方法将98例需要进行腰椎板切除术的患者分为两组,A组保留黄韧带,B组切除黄韧带,分别于术后3个月、1年进行随访,采用日本矫形学会(JOA)标准进行评分,计算改善率,并在1年时行CT扫描。结果术后3个月A组改善率与B组比较,差异无统计学意义(P>0.05);术后A组1年与B组比较,差异有统计学意义(P<0.05)。结论保留黄韧带能有效防止椎板切除术后硬膜外瘢痕粘连,远期临床疗效好。

Objective To evaluate the effection of retain ligamentum flavum in preventing the dura adhesive in the epidural.Methods A total of 98 patients were divided into two groups randomly.Both groups were disposed with lumbar discectomy,differentiated from each other by ligamentum flavum operation.Group A：retain ligamentum flavum.group B：clear ligamentum flavum.Follow up analysis was conducted 3 months and 1 year after operation,which were evaluated by the JOA（15 points）,and the improvement ratio were calculated.Underwent CT scanning was done one year after operation.Results There was no significant difference in the improvement ratio between two groups 3 months after operation（P0.05）.The improvement ratio of group A was better than group B in 1 years.Conclusion Retain ligamentum flavum is effective in preventing the scar formation after the operation,the clinical outcomes are better than the method of clear ligament.