后路内窥镜下经单侧切口及双侧切口行双侧神经根减压治疗腰椎间盘突出症的对比研究

发布时间：2018-01-03 02:32

本文关键词：后路内窥镜下经单侧切口及双侧切口行双侧神经根减压治疗腰椎间盘突出症的对比研究　出处：《西部医学》2016年12期 　论文类型：期刊论文

【摘要】：目的对经后路内窥镜下单侧切口及双侧切口行双侧神经根减压治疗腰椎间盘突出症疗效进行对比研究。方法将2010年10月~2012年10月收治的保守治疗无效伴双侧神经根受压的81例中央型腰椎间盘突出症患者随机分为实验组43例和对照组38例,实验组采取经单侧切口入路行双侧神经根减压及椎间盘切除术,对照组采取传统的双侧切口行双侧神经根减压及椎间盘切除术,对两种术式系列指标包括术中出血量、手术持续时间、切口长度、术后下床时间、术后住院天数、并发症及视觉模拟评分(VAS)、Macnab评分进行比较分析。结果 1实验组较对照组切口小,术中出血量少,手术时间短,两组间差异有统计学意义(均P0.05);而住院时间及术后下床时间差异无统计学意义(P0.05)。2两组术后1个月、末次随访,VAS评分与术前相比,均明显下降(P0.05);两组间术前、术后1个月及末次随访VAS评分差异无统计学意义(均P0.05)。3实验组Macnab评分,术后1个月优良率93.0%,末次随访优良率95.3%;对照组术后1个月优良率97.4%,末次随访优良率97.4%,组间差异无统计学意义(P0.05)。结论经后路内窥镜下单侧切口行双侧神经根减压治疗腰椎间盘突出症是一种安全、有效、微创的治疗方案,具有临床应用价值。
[Abstract]:Objective to compare the curative effect of unilateral and bilateral incision on lumbar disc herniation by posterior endoscope. Methods from October 2010 to October 2012, the conservative treatment of lumbar intervertebral disc herniation was carried out. 81 patients with central lumbar disc herniation were randomly divided into experimental group (n = 43) and control group (n = 38). The experimental group was treated with bilateral nerve root decompression and discectomy via unilateral incision, while the control group was treated with bilateral nerve root decompression and discectomy with traditional bilateral incision. For the two types of surgical procedures, including intraoperative bleeding, operative duration, incision length, postoperative time out of bed, postoperative hospital days, complications and visual analogue score (VASs). Results 1in the experimental group, the incision was smaller, the amount of intraoperative bleeding was less, the operation time was shorter, and the difference between the two groups was statistically significant (P 0.05). However, there was no significant difference in the length of hospitalization and the time of getting out of bed after operation. The VAS score of the last follow-up group was significantly lower than that of the pre-operation group (P 0.05). There was no significant difference in VAS score between the two groups before operation, 1 month after operation and the last follow-up (P0.05.3), and the excellent and good rate was 93.0% at one month after operation. The excellent and good rate of the last follow-up was 95. 3%; In the control group, the excellent and good rate was 97.4% 1 month after operation, and the excellent and good rate was 97.4% at the last follow-up. Conclusion it is safe, effective and minimally invasive to treat lumbar disc herniation with bilateral nerve root decompression through unilateral incision under posterior endoscope. It has clinical application value.
【作者单位】： 363医院骨科;
【基金】：四川省科技厅支撑课题(2013JY0156)
【分类号】：R687.3
【正文快照】： 后路内窥镜下髓核摘除术治疗腰椎间盘突出症疗效肯定,且创伤小,恢复快,随着后路椎间盘镜在临床上的广泛应用,治疗适应证逐渐扩展。2010年10月~2012年10月,我院对经后路内窥镜下单侧切口与双侧切口行双侧神经根减压治疗腰椎间盘突出症进行了对比研究,均取得了良好的临床疗效,现

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