微创小切口椎间盘切除术治疗腰椎间盘突出症的远期疗效

Long-term effect of microtraumtic discectomy in the treatment of lumbar disc herniation disease

目的探讨微创小切口椎间盘切除术(MTD)治疗腰椎间盘突出症的远期疗效。方法对86例MTD治疗的腰椎间盘突出患者进行为期5年的随访。分析其日本骨科学会评估治疗(JOA)评分及疗效维持情况。结果术前JOA总评分平均为(6.2±1.8)分,术后6个月、1年、2年及5年分别升至(23.1±5.8)分、(24.8±4.2)分、(24.9±4.3)分、(24.5±4.6)分,均较术前显著升高,差异有统计学意义(P<0.01);并且术后1年、2年及5年JOA评分稳定。JOA症状改善率为优的有48例(85.7%),良6例(10.7%),中及差各1例(1.8%),且长期随访发现疗效稳定。结论 MTD治疗腰椎间盘突出症患者长期疗效显著并稳固,在准确定位并熟练掌握操作要领的基础上,适合于各级医院开展。

Objective To explore the long-term effect of microtraumtic discectomy（MTA） in the treatment of lumbar disc herniation disease.Methods 86 patients with lubar intervertebral disc protrusion arranged MTD were followed up for 5 years,The Japanese orthopaedic society assessment of treatment（JOA） score and maintained curative effects were analyzed.Results The symptom score was increased until 6 months（23.1±5.8）,1 year（24.8±4.2）,2 years（24.9±4.3） and 5 years（24.5±4.6） after operation compared to preoperation（6.2±1.8）（P0.01）.Symptom improvement rate of JOA for optimal had 48 cases（85.7%）,benign in 6 cases（10.7%）,and poor in 1 case（1.8%） Long-term follow-up indicated that curative effect was stable.Conclusion MTD in patients with lumbar disc herniation could be with significant long-term efficacy and stableness,and could be carried out at all levels of hospitals on the basis of accurate positioning and skilled in operating essentials.