Quadrant可扩张通道显微镜下手术治疗腰椎间盘突出症的研究

Surgery for the treatment of lumbar disc herniation under Quadrant expandable channel microscopy

目的探讨腰椎间盘突出症应用Quadrant可扩张通道系统显微镜下不同手术方法治疗的临床效果。方法选择2017年3月~2018年4月腰椎间盘突出症患者40例为研究对象,按随机数表法分为单侧组和双侧组各20例,患者均应用Quadrant可扩张通道系统显微镜下手术,对单侧组实施单侧钉棒系统固定治疗,对双侧组实施双侧钉棒系统固定治疗,分析患者手术指标、术后并发症、JOA评分变化、疗效。结果单侧组患者术中出血量、手术时间、手术切口长度、术后住院时间、单病种总医疗费用低于双侧组,差异有统计学意义(P<0.05)。患者术后脊柱稳定性均良好,术后1年植骨融合。单侧组术后并发症发生率、术后1年恢复优良率与双侧组比较,差异无统计学意义(P>0.05)。单侧组术后1周JOA评分高于双侧组,差异有统计学意义(P<0.05)。结论应用Quadrant可扩张通道系统显微镜下手术治疗腰椎间盘突出症效果良好,并发症少,且实施单侧钉棒系统固定时比双侧固定创伤更小,早期恢复效果更好。

Objective To investigate the clinical effects of different surgical methods for the treatment of lumbar disc herniation under Quadrant expandable channel system microscopy. Methods Forty patients with lumbar disc herniation from March 2017 to April 2018 were enrolled in the study. They were divided into one-sided group and two-sided group according to the random number table method, with 20 cases in each group. The patients were all treated with surgery under Quadrant expandable channel system microscopy. The one-sided group was treated with unilateral nail rod system fixation therapy, and the two-sided group was treated with bilateral nail rod system fixation therapy. The patient's surgical index status, postoperative complications, JOA score change and curative effect were analyzed. Results The intraoperative blood loss, operative time, length of surgical incision, postoperative hospital stay, and total medical cost of single disease were lower in the one-sided group than those in the two-sided group(P<0.05). The patient's postoperative spinal stability was good, and bone graft fusion was performed at 1 year after surgery. The incidence of postoperative complications and the rate of recovery at 1 year after surgery in the one-sided group were not significantly different from those in the two-sided group(P>0.05). The JOA score was higher in the one-sided group than that in the two-sided group at 1 week after surgery, and the difference was statistically significant(P<0.05). Conclusion The use of Quadrant expandable channel system microsurgery for the treatment of lumbar disc herniation has a good effect and less complications, and the one-sided nail rod system fixation has smaller trauma and better early recovery effect than that of double-sided fixation.