应用侧后路椎间孔镜治疗中央型腰椎间盘突出症

Foraminal Endoscopic Discectomy in the Treatment of Centeral Lumbar Disc Herniation

目的探讨腰侧后路椎间孔镜下髓核摘除术治疗中央型腰椎间盘突出症的技术操作特点和临床疗效。方法2010年2月至2011年1月,对20例中央型腰椎间盘突出的患者行腰侧后路椎间孔镜下髓核摘除术手术治疗,男8例,女12例;年龄33~60岁,平均47.5岁。病程3~10年,平均6年5个月。比较分析20例患者术前、术后1周、术后3个月、术后6个月、术后12个月、末次随访腰腿疼痛的视觉模拟评分（visual analogue scale,VAS）及末次随访Macnab评分。结果 20例患者术后均获得随访,随访时间12~23个月,平均18.3个月。术后VAS评分与术前相比均明显降低,差异有统计学意义（P〈0.05）。按照Macnab评分标准进行疗效评价,末次随访时优10例,良8例,可1例,差1例,优良率为90.0%（18/20）。结论在熟悉掌握操作技术的前提下,使用椎间孔镜术治疗中央型腰椎间盘突出症在短期内能取得满意的临床疗效。

Objective To explore the clinical efficacy and technical characteristics of the foraminal endoscopic discectomy in the treatment of centeral lumbar disc herniation.Methods From February 2010to 2011January,20cases of centeral lumbar disc herniatio were treated with endoscopic discectomy.There were 12females and 8males age 33to 60 years（average of 47.5years）.Course ranged from 3to 10years（mean 6.5years）.VAS scores and Macnab score before operation,1week,3months,6months and 12months after opration were analyzed.Results 20patients were followed up for an average of 18.3months（12to 23months）.The VAS scores for main complaints during the followed up time and the final follow-up showed significant differences compared with preoperative ones（P﹤0.05）.The excellent-to-good rate of Macnab score at last followed up were excellent in 10cases,good in 8cases,fair in 1case,poor in 1case; which showed significant difference compared with preoperation（P﹤0.05）.Conclusion Endoscopic discectomy in the treatment of centeral lumbar disc herniation can achieve a satisfactory short term clinical efficacy.