经单侧椎板间隙髓核摘除术与椎板开窗髓核摘除术治疗腰椎间盘突出症疗效比较

Comparison of therapeutic effects of interlaminar space discectomy and fenestration discectomy for treatment of lumbar disc herniation

目的对比分析经单侧椎板间隙髓核摘除术与椎板开窗髓核摘除术治疗腰椎间盘突出症的临床疗效。方法选取2012年1月~2015年1月在我院确诊为腰椎间盘突出症、需行手术治疗且符合入组标准的患者100例,随机分为A组和B组,每组50例,A组行经单侧椎板间隙髓核摘除术,B组行椎板开窗髓核摘除术,随访18个月,比较两种手术方法的临床疗效。结果两组患者术后1周时的CSA评定无统计学差异(P=0.683);两组患者在术后1个月(P=0.070)、术后6个月(P=0.494)、术后18个月(P=0.536)时JOA评分均无统计学差异;两组患者的手术时间无统计学差异(P=0.308),但A组患者的术中出血量(P=0.000)、术后卧床时间(P=0.000)及术后住院时间(P=0.000)均显著优于B组。结论经单侧椎板间隙髓核摘除术可达到与椎板开窗髓核摘除术相同的临床疗效,但可显著减少术中出血量及缩短术后卧床和住院时间,优势明显,值得在基层医院推广。

Objective To compare the clinical efficacy of interlaminar space discectomy and fenestration discectomy for treatment of lumbar disc herniation. Methods One hundred patients with low lumbar disc herniation from Jan 2012 to Jan 2015 were randomly divided into interlaminar space discectomy group(group A) and fenestration discectomy group(group B) and 50 cases in each group. Results The postoperative CSA evaluation at 1 week after operation had no significant difference between two groups(P=0.683).The JOA score at 1 month,6 months,18 months after operation had no significant difference between two groups(P=0.070,P=0.494,P=0.536).The operation time had no significant difference between two groups(P=0.308),but the intraoperative blood loss,the postoperative bed time and hospitalization time were significantly different between two groups(P=0.000,P=0.000,P=0.000).Conclusion The similar clinical efficacy can be obtained from the interlaminar space discectomy and fenestration discectomy,but the intraoperative blood loss and the postoperative bed time and hospitalization time of interlaminar space discectomy are significantly better than fenestration discectomy.