腰椎后路肌间隙入路在腰椎间盘突出症患者手术中的应用效果

Clinical Effect of Lumbar Intervertebral Disc Herniation by Surgical Treatment of Lumbar Intervertebral Space

目的探讨腰椎间盘突出症患者手术中采取腰椎后路肌间隙入路的应用效果。方法选取2016年3月至2017年3月接受手术治疗的102例腰椎间盘突出症患者作为研究对象,通过随机数字表法分为试验组和对照组,各51例。对照组采取腰椎后路正中切口入路,试验组采取腰椎后路肌间隙入路。对比两组手术时间、术中出血量、术后卧床时间、术后疼痛程度、术中神经损伤情况及腰椎功能恢复效果。结果两组手术时间、术中出血量、术后卧床时间比较,差异均无统计学意义(P>0.05);试验组术后视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。两组术中神经损伤发生率比较,差异无统计学意义(P>0.05)。术后随访评测,试验组Macnab评分优良率为90.2%,高于对照组的78.4%,差异有统计学意义(P<0.05)。结论在腰椎间盘突出症患者手术治疗中,行腰椎后路肌间隙入路,术后疼痛轻,恢复快,预后良好,值得临床实践应用。

Objective To explore the clinical effect of lumbar intervertebral disc herniation by surgical treatment of lumbar intervertebral space. Methods 102 cases of lumbar spine in March 2016-2017 year in March in our hospital accepted surgical treatment of lumbar disc herniation patients were enrolled in the study,by randomly divided into study group and control group,51 cases in each group; take routine lumbar posterior midline approach,explore the group adopted posterior lumbar paraspinal approach,hemorrhage by comparing the two groups of operation time,intraoperative nerve injury,and grasp the situation,the application of visual simulation method(VAS) degree of pain evaluation after surgery; postoperative follow-up of 6 months,the application of Macnab standard to evaluate the recovery effect of lumbar function. Results The group postoperative VAS score was significantly lower than normal group,the difference was statistically significant(P < 0. 05),but the operation time,intraoperative bleeding volume and the incidence of nerve injury had no significant difference(P > 0. 05); follow-up evaluation,research group Macnab score excellent rate was 90. 9%,significantly higher than the control group 80%(P < 0. 05). Conclusion In the surgical treatment of lumbar disc herniation,the posterior lumbar intermuscular space approach has less postoperative pain,faster recovery and better prognosis,which is worthy of clinical practice.