小切口开窗术治疗腰椎间盘突出症合并腰椎管狭窄的临床疗效观察

Observation on clinical efficacy of mini-incision fenestration treating lumbar disc herniation combined with lumbar spinal stenosis

目的探讨小切口开窗髓核摘除术治疗腰椎间盘突出症合并腰椎管狭窄的临床价值。方法选取2009-2012年本院收治的110例腰椎间盘突出症合并腰椎管狭窄患者,随机分为两组,分别行传统手术与小切口开窗术。结果两组患者手术均顺利完成,且日本骨科协会评估治疗分数（JOA）与视觉模拟评分法（VAS）评分均明显改善,观察组患者JOA与VAS评分改善显著优于对照组,神经功能改善优良率明显高于对照组,术后复发率显著低于对照组。治疗前后两组患者X线椎管间隙与椎间孔无明显变化。结论小切口开窗术能够有效治疗腰椎间盘突出症合并腰椎管狭窄,相比传统手术,患者神经功能恢复与疼痛改善效果更明显,可有效减少术后复发,建议在临床治疗中推广应用。

Objective To observe the clinical value of mini-incision fenestration treating lumbar disc herniation combined with lumbar spinal stenosis. Method 110 cases with lumbar disc herniation combined with lumbar spinal stenosis treated in our hospital from 2009 to 2012 were selected and divided into two groups randomly. Two groups were treated with traditional operation and mini-incision fenestration. Result The operation of two groups was successful. JOA and VAS score improved evidently. The improvement of JOA and VAS score in observation group were evidently better than that of control group, the excellent rate of neurological function improvement was evidently higher than that of control group, and the recurrence rate after operation was evidently lower than that of control group. There was no evident difference for X ray spinal canal and space before and after treatment. Conclusion Mini-incision fenestration can evidently treat lumbar disc herniation combined with lumbar spinal stenosis. Compared with traditional operation, it has better effect of neural functional recovery and pain improvement, and can reduce the recurrence rate after operation, worthy of promotion and application in clinical practice.