显微镜辅助下经通道固定融合术治疗腰椎间盘突出症

Microscopically assisted trans-channel fixation fusion for the treatment of lumbar disc herniation

目的观察显微镜辅助下经通道固定融合术治疗腰椎间盘突出症的临床疗效。方法 采用显微镜辅助下经通道固定融合术治疗26例腰椎间盘突出症患者。记录手术时间、术中出血量、术后引流量、术后并发症。采用疼痛VAS评分及ODI评分评估手术疗效,采用改良MacNab标准评估手术的优良率,术后定期复查并统计椎间融合率。结果 手术时间130~180(160.0±15.2)min,术中出血量100~150(120.0±36.3)ml,术后引流量45~75(55.0±15.3)ml。患者均获得随访,时间12~22(15.4±5.9)个月。VAS评分、ODI评分术后3、12个月与术前比较差异均有统计学意义(P<0.05),术后12个月与术后3个月比较差异无统计学意义(P>0.05)。术后12个月采用改良MacNab标准评估手术优良率为24/26。术后复查椎间植骨融合良好,融合率100%,无内固定松动、断裂等情况。结论 显微镜辅助下经通道固定融合术治疗腰椎间盘突出症椎间融合率和优良率均满意。

Objective To observe the clinical effect of the treatment of lumbar disc herniation by microscopically assisted trans-channel fixation fusion. Methods The 26 patients with lumbar disc herniation were treated with trans-channel fixation and fusion assisted by microscopy,the operation time,intraoperative bleeding volume,postoperative drainage volume and postoperative complications were recorded.VAS and ODI score were used to evaluate the surgical efficacy.The improved MacNab standard was used to evaluate the excellent-good rate of surgery.The intervertebral fusion rate was regularly reviewed after surgery. Results The operation time was 130~180(160.0±15.2) min.The intraoperative bleeding volume was 100~150(120.0±36.3)ml.Postoperative drainage volume was 45~75(55.0±15.3) ml.All patients were followed up for 12~22(15.4±5.9)months. There were statistical differences for VAS and ODI score between 3,12 months postoperation and preoperation( P <0.05),there were no significant differences between 12 months after operation and 3 months after operation ( P >0.05).At 12 months postoperation,the effect evaluation excellent-good rate according to improved MacNab standard criteria for surgery was 24/26.The intervertebral bone graft fusion was good,the fusion rate was 100% and there was no internal fixation loosening and fracture. Conclusions The trans-channel fixation fusion assisted with microscopy for lumbar disc herniation has satisfactory intervertebral fusion rate and good excellent-good rate.