椎间盘镜下髓核摘除术治疗伴有Modic改变的腰椎间盘突出症

Microendoscopic discectomy for lumbar disc herniation with Modic change

目的探讨椎间盘镜下髓核摘除术(MED)治疗伴Modic改变的腰椎间盘突出症的临床疗效。方法将60例腰椎间盘突出症患者按病变类型分为单纯腰椎间盘突出症组(30例)和伴有Modic改变的腰椎间盘突出症组(30例),两组患者均行MED治疗并对比疗效。疗效评定采用疼痛视觉类比评分(VAS)和Oswestry功能障碍指数评分(ODI)。结果术后两组VAS、ODI评分与术前比较差异有统计学意义(P<0.05)。术后两组间腿痛缓解比较差异无统计学意义(P>0.05),但ODI及下腰痛VAS评分比较差异有统计学意义(P<0.05)。结论腰椎Modic改变与患者术后下腰痛恢复情况密切相关,提示腰椎Modic改变是下腰痛的原因之一,对腰椎间盘镜下髓核摘除术临床疗效有影响。

Objective To assess the efficacy of the microendoscopic discectomy for lumbar disc herniation with Modic change.Methods Sixty patients with lumbar disc herniation showing normal（A group,n=30）or endplate Modic change in their bone marrow （B group,n=30）underwent microendoscopic discectomy were enrolled.The clinical outcomes were compared in terms of the score on visual-analogue scale （VAS）for low back pain and the score on Os-westry disability index （ODI）before and after surgery.Results Compared with preoperation,there were significant difference in postoperative score of VAS and ODI in both groups （P〈0.05 ）.There were no significant statistical difference of leg pain between the two groups,however,there were significant difference in postoperative score of ODI and VAS of low back pain in between the two groups （P〈0.05 ）.Conclusions Modic change has correlation with low back pain and affects the outcomes of treatment of MED for lumar disc herniation.