椎间盘镜与开放手术治疗腰椎间盘突出症的对比研究

A comparative study on efficacy of microendoscopic discectomy and fenestration discectomy in treatment of lumbar disc herniation.

目的比较椎间盘镜和椎板开窗髓核摘除术治疗腰椎间盘突出症的临床疗效和安全性。方法回顾性分析80例单节段腰椎间盘突出症患者的病历资料,采用椎间盘镜治疗者42例(治疗组),采用椎板开窗髓核摘除术治疗者38例(对照组)。比较两组患者的切口长度、手术时间、出血量、术后12个月随访时采用Nakai分级标准评定的临床疗效及随访期间并发症的发生率。结果治疗组切口长度、手术时间及术中出血量均小于对照组(P<0.05)。两组患者临床疗效比较,差异无统计学意义(Z=-0.696,P=0.486)。两组患者切口均甲级愈合,未发生神经根损伤、椎间隙感染及硬膜外血肿等并发症。结论椎间盘镜手术和椎板开窗髓核摘除术治疗腰椎间盘突出症的临床疗效和安全性相当,但前者具有切口小、手术时间短及出血少的优势。

Objective To compare the clinical effect and safety of microendoscopic discectomy and fenestration discectomy in treatment of patients with lumbar disc herniation. Methods The medical data of 80 patients performed surgery for lumbar disc herniation were retrospectively analyzed. Forty - two patients in trial group were performed with microendoscopic discectomy,while the remaining patients（control group）were given with fenestration discectomy. The effects of surgery in patients of these 2 groups were compared with each other in such parameters as length of incision,operating time,amount of blood loss,curative effect and incidence rate of complications. Results The length of incision,operating time and amount of blood loss in trial group were less than those of control group respectively（P﹤0. 05）. There was no statistically difference in curative effect（Z=-0. 696,P=0. 486）. All patients in these 2 groups got primary healing in operative incisions and no complications such as injury of nerve root,disc space infection and epidural hematoma were found. Conclusion The therapeutic effect and safety of microendoscopic discectomy is similar to that of fenestration discectomy in treatment of lumbar disc herniation,while the former has the advantages of less invasiveness, shorter operating time and less blood loss.