后路椎间盘镜髓核摘除术治疗腰椎间盘突出症的远期疗效分析

The evaluation on long-term effect of posterior microendoscopic descetomy for patients with lumbar disc herniation

目的：分析后路椎间盘镜髓核摘除术（microendoscopic descetomy,MED）治疗腰椎间盘突出症的远期疗效。方法：选取2009年1月至2012年1月间在我院接受MED腰椎间盘突出症的35名患者为对象,并以同期接受开放式手术的43名患者为对照,比较两组手术时间、术中出血量、术后住院时间、VAS和ODI评分及复发率等指标的差异。结果：平均随访23.5（13-50）个月,MED组平均手术时间为（89.6±23.6）min,比OD组长;平均住院时间为7（5-27）d,比OD短,术中出血量为60（20-250）m L,与OD组无差异。两组VAS和ODI评分均随时间延长而明显降低,但两组间无明显差异。两组复发率分别为7.1%和8.7%,也无明显差异。结论：MED与OD手术整体疗效无明显差异,但MED明显缩短住院时间。

Objective：To evaluate the long-term effect of microendoscopic descetomy （ MED） for patients with lumbar disc herniation（LDH）. Methods：Thirty-five patients who were hospitalized for LDH and accepted MED during Jan. 2009 to Jan. 2012 in our hospital were selected as study subjects. Forty-three patients who accepted OD during the same period were selected as control. Compar-isons of surgical time, blood loss, time of hospital stay, VAS and ODI score, as well as recurrence rate were performed between two groups. Results：The mean following-up time was 23. 5 months （13-50）. In MED group,the mean surgical time was （89. 6 ＆#177; 23. 6） minutes,longer than that in OD group. The mean duration of hospital stay was 7（5-27）days,shorter than that in control group. Blood loss during operation was 60（20-250）mL,comparative to that in OD group. VAS and ODI scores were decreased with time and no sig-nificant difference was found between groups. The recurrence rate was 7. 1% in MED group and 8. 7% in OD group. Conclusion：The o-verall effects were comparative between MED and OD,but MED can obviously shorten the length of hospital stay.