显微内窥镜椎间盘切除术治疗腰椎椎间盘突出术后复发

Micro-endoscope discectomy for recurrent lumbar disc herniation

目的研究后路经椎板间隙入路显微内窥镜椎间盘切除术（Micro-endoscope discectomy,MED）治疗腰椎椎间盘突出术后复发的临床疗效。方法选取本院2003年6月~2013年6月诊断为腰椎椎间盘突出术后复发并行手术治疗患者61例,根据治疗手术方式分为观察组和对照组。观察组行MED手术,患者23例;对照组行后入路固定融合术,患者38例。统计2组术中出血量、手术时间及日本骨科学会（Japanese Orthopaedic Association,JOA）评分、疼痛视觉模拟量表（visual analogue scale,VAS）评分等情况,用SPSS 20.0统计软件进行统计分析。结果 2组患者在术中出血量、手术时间方面相比,差异有统计学意义（P〈0.05）,而术后JOA、VAS评分比较,差异无统计学意义（P〉0.05）。结论 MED治疗腰椎椎间盘突出术后复发中期临床效果满意,并将是今后脊柱外科的发展的重点、热点。

Objective To study the clinical efficacy of micro-endoscope discectomy（ MED） in treatment of recurrent lumbar disc herniation. Methods Form 2003 June to 2013 June,61 cases diagnosis of recurrent lumbar disc herniation were included in the research. According to the therapeutic operation mode,divided into 2 groups. The observation group 23 cases underwent MED,and control group 38 cases underwent posterior arthrodesis fixation and fusion. The bleeding volume,operation time,Japanese Orthopaedic Association（ JOA） score,visual analogue scale（ VAS） score were recored. Statistical analysis was performed by SPSS 20. 0. Results The bleeding volume,operation time of the 2 groups had significant difference（ P〈0. 05）,but the postoperative JOA score and VAS score had no significant differences（ P〉0. 05）. Conclusion The mid clinical effect of MED for treatment of recurrence lumbar disc herniation is satisfactory. And the technology will become hot spot and focal pointf on the development of spine surgery