Quadrant通道下治疗老年性腰椎间盘突出症的近期疗效观察

发布时间：2019-01-27 05:55

【摘要】：目的观察Quadrant通道下治疗老年性腰椎间盘突出症的临床疗效。方法 Quadrant通道下治疗老年性腰椎间盘突出症54例。其中男30例,女24例;年龄62~76岁,平均(67.3±4.52)岁。手术节段:L3/46例,L4/5 14例,L5/S1 34例。患者均行X线片、MRI检查确诊单纯的椎间盘突出,无节段不稳。末次随访时采用疼痛视觉模拟评分(VAS),改良下腰痛ODI评分、改良Mac Nab标准评定患者症状改善情况。结果手术时间30~90 min,平均(50.00±7.53)min;术中出血量30~100 m L,平均(60.0±12.5)m L。手术切口有3例延迟愈合;术中2例发生脑脊液漏,未行修补,术后2 d拔除引流管,行皮肤缝合后切口愈合。术后无椎间隙感染、神经损伤等并发症发生。全部病例获完整随访,随访时间12~36个月,平均(20.00±3.53)个月。末次随访时,VAS评分由术前的(7.25±0.68)分降至(1.83±0.59)分,差异有统计学意义(t=13.14,P=0.00)。ODI%评分由术前的(74.08±5.31)分降至(28.20±3.10)分,差异有统计学意义(t=7.68,P=0.00)。按改良Mac Nab标准评价疗效,优40例,良8例,中6例,优良率88.9%。结论 Quadrant通道下椎间盘突出髓核摘除术具有创伤小、并发症少等优点,是治疗老年性腰椎间盘突出症的一种安全有效的微创手术方法。
[Abstract]:Objective to observe the clinical effect of Quadrant channel in the treatment of senile lumbar disc herniation. Methods 54 cases of senile lumbar disc herniation were treated with Quadrant channel. There were 30 males and 24 females, with an average age of (67.3 卤4.52) years. Surgical segment: l 3 / R 46 cases, L 4 / 5 14 cases, L5/S1 34 cases. All patients underwent X-ray and MRI examination confirmed simple disc herniation without segmental instability. At the last follow-up, pain visual analogue score (VAS),) was used to improve the ODI score of low back pain, and the modified Mac Nab standard was used to evaluate the improvement of symptoms. Results the mean time of operation was (50.00 卤7.53) min;, the mean time of operation was (30 卤7.53) min;, the mean blood loss was (60.0 卤12.5) m L.). Cerebrospinal fluid leakage occurred in 2 cases, no repair was performed, drainage tube was pulled out 2 days after operation, incision healed after skin suture. There were no postoperative complications such as intervertebral space infection and nerve injury. All patients were followed up for 12 ~ 36 months (mean (20.00 卤3.53) months). At the last follow-up, the VAS score decreased from (7.25 卤0.68) to (1.83 卤0.59), and the ODI% score decreased from (74.08 卤5.31) to (28.20 卤3.10). The difference was statistically significant (t = 7.68, P < 0.001). According to the improved Mac Nab criterion, the curative effect was evaluated in 40 cases, good in 8 cases and fair in 6 cases. The excellent and good rate was 88.9%. Conclusion Quadrant channel excision of nucleus pulposus herniated intervertebral disc has the advantages of less trauma and less complications. It is a safe and effective minimally invasive method for the treatment of senile lumbar disc herniation.
【作者单位】：清远市人民医院骨科一区;
【基金】：广东省医学科学技术研究基金项目(编号:A2015222)
【分类号】：R687.3

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