椎间孔入路微创手术与椎板开窗治疗复发性腰椎间盘突出症的效果比较

Effect of intervertebral foramen lumbar microdiscectomy and vertebral lamina fenestration discectomy to recurrent disc herniation

目的经皮椎间孔镜微创治疗复发性腰椎间盘突出症的效果。方法回顾性分析2010年6月～2015年11月行微创椎间孔镜下椎间盘髓核切除术和传统椎板扩大开窗髓核摘除术治疗的腰椎间盘突出术后复发患者的病历资料，统计描述病人的性别、年龄、复发节段，比较两种术式在手术时间、术中失血量、术后卧床时间和住院时间的差异；随访6个月以上，采用疼痛视觉模拟评分（VAS）及疗效优良率（Macnab标准）比较两种手术方式的临床疗效。结果两组病人手术时间和住院时间比较，差异无统计学意义（P〉0．05）；两组病人术中失血量和术后卧床时间比较，差异有统计学意义（P〈0．05）；两组病人术后6个月VAS评分的降低率、疗效优良率比较，差异均有统计学意义（P〈0．05）。结论经皮椎间孔镜微创治疗复发性腰椎间盘突出术中出血少，恢复快，临床疗效良好。

Objective To study the effect of microscopical treatment to recurrent lumbar disc herniation in the intervertebral foramen. Methods The data of the recurrence of intervertebral disc treated with MED and vertebral lamina fenestration from January 2010 to June 2016 were celected. The operation time, intraoperative blood loss and postoperative walk time were observed. The clinical curative effect was evaluated with visual analogue scale （VAS） and the Macnab criteria. Results There was no statistical significance difference between the two groups in operation time and hospitalization time. There were statistical significant difference in intraoperative blood loss and postoperative bed time between the two groups. There were statistical significance differences between the two groups in VAS score reduce rate and the excellent rate. Conclusion There is good effect of intervertebral foramen microscopically treatment to recurrent lumbar disc herniation.