Objective To evaluate the long-term outcomes of fenestrated discectomy for lumbar disc herniation and analyze the correlative influence factors. Methods Eighty-two cases of lumbar disc herniation, from February 1996 t...Objective To evaluate the long-term outcomes of fenestrated discectomy for lumbar disc herniation and analyze the correlative influence factors. Methods Eighty-two cases of lumbar disc herniation, from February 1996 to May 1999, were retrospectively studied. All patients were treated with simple fenestrated discectomy. The average follow-up time was 8 years and 7 months (from 7 years tolO years and 3months). There were 13, 38 and 31 cases at 13 - L4, L4 - L5 and L5 - S1 level, respectively. Results The average scales before operation were as following : Japanes Orthopaedics Association ( JOA ) scale 6. 5 ( 5 - 9 ) , visual analysis scale ( VAS) of low back pain4.8 (0-8). and VAS of sciatica 7.2 (4-10). At the final follow-up, the above parameters were 13.2 ( 10 - 14 ), 1.8 (0 - 10) and 1.2 (0 - 7), respectively. The average increase ratio of JOA scale was 78. 8%. The average disc-vertebra height ratio ( Mochida method) was 80.2%. At the final follow-up, 7 cases reoccurred disc herniation. The final clinical satisfaction rate was 80% ( modified Macnab method ). Conclusion With appropriate surgical indications, the successfid long-term outcomes could be expected with fenestrated discectomy. Discectomy improves sciatica to a greater extent than low back pain. The occurrence of low back pain is related to intervertebral disc height, segment stability, disc degeneration, and lumbar muscle disability.展开更多
文摘Objective To evaluate the long-term outcomes of fenestrated discectomy for lumbar disc herniation and analyze the correlative influence factors. Methods Eighty-two cases of lumbar disc herniation, from February 1996 to May 1999, were retrospectively studied. All patients were treated with simple fenestrated discectomy. The average follow-up time was 8 years and 7 months (from 7 years tolO years and 3months). There were 13, 38 and 31 cases at 13 - L4, L4 - L5 and L5 - S1 level, respectively. Results The average scales before operation were as following : Japanes Orthopaedics Association ( JOA ) scale 6. 5 ( 5 - 9 ) , visual analysis scale ( VAS) of low back pain4.8 (0-8). and VAS of sciatica 7.2 (4-10). At the final follow-up, the above parameters were 13.2 ( 10 - 14 ), 1.8 (0 - 10) and 1.2 (0 - 7), respectively. The average increase ratio of JOA scale was 78. 8%. The average disc-vertebra height ratio ( Mochida method) was 80.2%. At the final follow-up, 7 cases reoccurred disc herniation. The final clinical satisfaction rate was 80% ( modified Macnab method ). Conclusion With appropriate surgical indications, the successfid long-term outcomes could be expected with fenestrated discectomy. Discectomy improves sciatica to a greater extent than low back pain. The occurrence of low back pain is related to intervertebral disc height, segment stability, disc degeneration, and lumbar muscle disability.