腰椎间盘突出症术后的中远期疗效分析

Analysis of the Long-term Efficacy of Postoperative Lumbar Disc Prolapse

目的:回顾性分析腰椎间盘突出症患者术后的中远期疗效和预后情况并对手术疗法的效果作出评价。方法:以1995年12月到2014年12月期间在我院骨科接受治疗的腰椎间盘突出患者825例作为研究对象,对患者进行术后的跟踪回访,观察其术后的中远期疗效。结果:患者经术后随访效果均较佳,中期随访的患者优良率为94.2%,中长期随访的患者优良率为85.3%,超长期随访患者的优良率为80.0%;其中,中期效果最佳,与另外两组比较差异有统计学意义(P<0.05)。患者的治疗后改善指数均在60%以上,患者恢复效果较佳。中期、长期及超长期随访的患者改善指数分别为87.3%、81.2%和72.8%。中期随访的患者疗效最好,效果最明显,与超长期比较差异有统计学意义(P<0.05)。采用开窗髓核取出、全椎板切除减压及半椎板切除减压方法治疗,前两组的疗效比第三组预后好,优良率分别为94.1%、86.7%、85.5%,差异有统计学意义(P<0.05)。结论:采用手术治疗腰椎间盘突出症的中远期疗效较佳,患者预后恢复理想,腰椎功能恢复优良,临床推广使用价值高。

Objective： To retrospectively analyze the long-term curative effect and prognosis of patients with postoperative lumbar disc prolapse and evaluate the effect of the surgical therapy. Methods： 825 cases of patients with lumbar disc who received surgery in our hospital from December 1995 to December 2014 were selected as the research objects. The long-term curative effect after the operation was observed. Results： The curative effect of postoperative follow-up of patients was good, and the excellent rate of medium-term fol- low-up of patients was 94.2 %, and the excellent rate was 85.3 % in medium and long-term follow-up and 80.0 % in super long-term fol- low-up; and the medium-term effect was the best, had statistically significant difference compared with the other two groups （P〈0.05）. After treatment, the improvement index of patients reached above 60 %, The improvement index of medium-term, long-term and super long-term follow-up of patients was 87.3%, 81.2% and 72.8%, respectively, and it was the best in median term follow-up （P〈0.05）. By nucleus pulposus resection through small incision and lamina fenestration, the whole lamina resection of nucleus pulposus decompression and half lamina resection decompression method treatment, the curative effect of two groups before a better prognosis than the third group, the excellent （94.1%）, （86.7%）, respectively （85.5%）, the difference was statistically significant （P〈0.05）. Conclusions： The medi- um and long-term curative effect of surgical treatment is excellent for lumbar intervertebral disc protrusion with good prognosis and ideal lumbar functional recovery ideal.