老年腰椎间盘突出症患者不同介入疗法的选择与分析

The choice and analysis of different interventional therapy in aged patients with lumber intervertebral disc herniation

目的:探讨老年人腰椎间盘突出症的介入治疗方法及其相关问题。方法:对48例经临床及影像学检查确诊的老年腰椎间盘突出症患者根据其病情不同实施不同的介入治疗方法,其中经皮腰椎间盘切除术24例,化学溶核术6例,二者结合的双介入疗法18例,前两种方法主要用于腰椎间盘突出,后种方法用于腰椎间盘脱出、脱垂或双节突出的患者。结果:介入治疗成功率100%,经术后3个月～5年随访,显效35例(72.92%);有效11例(22.91%);无效2例(4.17%),总有效率为95.83%,无严重并发症。结论:介入治疗是治疗老年人腰椎间盘突出症的安全有效的方法,所合并的一般内科疾病不影响治疗。建议除正规的保守治疗外,老年腰椎间盘突出患者可首选介入治疗。

AIM:To investigate t he interventional t herapy in aged patients with lumbar intervertebral disc hern iation and related problems in therapy.METHODS:Forty-eight aged patients with lumb ar intervertebral disc herni-ation proved by clinical and imaging data we re treated with various interven-tional management according to their different conditions,in which percuta-neous lumbar discectomy (PLD)were 24cases,ch emonucleolysis(CNL)were6cases,combined therapy(APLD +CNL)were 18cases. The two former methods were used for lumbar disc pro trusion,and the latter was used for lumbar disc prolapse.RESULTS:T he success rate was 100%.After f ollo w-up of 3months to 5years,the apparently effective rate was 72.92 %(35cases),effective rate was22.91%(11cases),ineffective rate w as 4.17%(2cases),and the total effec-tive rate was 95.83%(46c ases),in which there was no severe complic ation.Interventional t herapy is a safe and effective management for aged patients with lumbar interv ertebral disc heniation.It is suggested that interventional therapy is the fir st choice to aged patients besides stan dard conservative therapy