常规开放与显微镜下小开窗治疗腰椎退行性疾病的疗效对比研究

Laminectomy and microsurgical nerve root decompression in the treatment of lumbar degenerative effect comparison

目的探讨常规开放与显微镜下小开窗治疗腰椎退行性疾病的疗效。方法 100例腰椎退行性变患者中采用传统全椎板切除术45例(传统组),采用显微神经根减压术55例(微创组),比较手术状况,并且采用日本骨科协会评估治疗分数(JOA)评价患者术前、术后1、12、24个月手术疗效。结果传统组术后卧床时间、住院时间、切口长度、术中出血量均长于或多于微创组;两组术后1、12、24个月JOA评分均高于术前,并且均在术后12个月JOA评分均最高,术后24个月降低,术后12、24个月微创组JOA评分均高于传统组评分;传统组治疗有效率为86.67%,低于微创组的98.18%(P<0.05)。结论显微神经根减压术治疗创伤小、住院时间短,并且术后恢复快,手术效果显著,值得临床推荐。

Objective To explore the effect of conventional open and small window underwent lumbar degenerative disease. Methods Among 100 cases of lumbar degenerative disease,45 cases were used traditional laminectomy（ traditional group）,55 cases were treated with nerve root decompression by microscopic（ minimally invasive group）,comparing the operation status,and for were evaluated before and after operation by the evaluation treatment scores of Japan Orthopedics Association（ JOA）. Results Those of the bed time,postoperative hospitalizations,bleeding time,incision length in traditional group were longer or more than the minimally invasive group.The JOA score of two groups at the month of 1,12 and 24 after operation was higher than before operation,and reached the highest level at the month12 after surgery,but at the month24 were reduced.The JOA score of the month 12,24 after surgery in minimally invasive group were higher than those of the traditional group.The effective rate of the traditional group was 86.67% lower than that of 98.18% in the minimally invasive group（ P〈0.05）. Conclusion Micro nerve root decompression treatment has the advantages of small trauma,short hospital stay and postoperative recovery,which operation effect is significant and worthy of clinical recommendation.