后路椎间盘镜手术与开放椎板开窗术治疗腰椎间盘突出症疗效比较

Comparison of the clinical curative effect between microendoscopic discectomy through posterior approach and open discectomy in the treatment of lumbar intervertebral disc protrusion

目的对比分析后路椎间盘镜手术与开放椎板开窗术治疗腰椎间盘突出症的临床效果。方法将2011年1月至2013年6月在新乡医学院第三附属医院进行手术治疗的腰椎间盘突出症患者124例按手术方法的不同分为椎间盘镜组和开放手术组,每组62例,分别行后路椎间盘镜手术和开放椎板开窗术。分析比较2组患者的手术状况、治疗效果和并发症。结果椎间盘镜组患者的手术时间、术中出血量和术后引流量均显著低于开放手术组(P<0.05)。椎间盘镜组患者治疗优良率显著高于开放手术组(P<0.05)。2组患者疼痛麻木、椎管血肿、神经损伤等并发症发生率经比较差异均无统计学意义(P>0.05)。结论与传统的开放椎板开窗术相比,后路椎间盘手术具有治疗效果好,创伤小等优点,且不增加并发症发生率。

Objective To compare and analyze the clinical curative effect of microendoscopic discectomy（ MED）through posterior approach and open discectomy（ OD） in the treatment of lumbar intervertebral disc protrusion. Methods A total of 124 patients with lumbar intervertebral disc protrusion who had operation in the Third Affiliated Hospital of Xinxiang Medical University from January 2011 to June 2013 were divided into MED group and OD group according to the different operation method,with 62 cases in each group. The patients in MED group and OD group were treated with MED and OD respectively. The operation condition,curative effect and complications between the two groups were compared and analyzed. Results The operation time,intraoperative bleeding,postoperative drainage in MED group were significantly lower than those in OD group（ P〈0. 05）. The fineness rate was significantly higher than that in OD group（ P〈0. 05）. There was no significant difference in complications such as pain and numbness,spinal hematoma,nerve injury（ P〉0. 05）. Conclusion Compared with OD,MED has the advantages of good curative effect,small trauma in treatment of lumbar intervertebral disc protrusion without increasing the incidence of complication.