腰椎间盘突出症58例标准开窗减压术的回顾性疗效分析

目的 通过对58例腰椎间盘突出症标准开窗减压术的回顾性疗效分析，探讨标准开窗术治疗腰椎间盘突出症的疗效。方法 收集我院自1990年2月-2002年3月135例腰椎间盘突出症患者行开窗术治疗的临床资料，进行术后1年疗效随访调查，并进行疗效评价分析。结果 可随访到58例，出院时患者症状均有改善；术后1年随访疗效改善率优者37例(63．8％)，良16例(27．6％)，差5例(8．6％)，随访结果的功能评分与手术前功能评分之间亦有显著差异。结论 标准开窗术具有创伤小、恢复早的优点。腰椎间盘突出症标准开窗术后不仅即刻就有功能的改善和良好疗效，而且开窗术式对腰椎间盘突出症的治疗具有一定的长期疗效。严格掌握手术指征，强调手术不仅要摘除突出的椎间盘、髓核，更应彻底扩大侧隐窝，松解被嵌压的神经根，以提高手术疗效。对其中有完整资料的58例总结分析如下。

An Retrospective analysis of standard Fenestration on 58 patients with the Lumbar Intervertebral Disc Heniation

Objective To Retrospective analyze the operative effect of 58 patients who were protrusion of lumbar intervertebral disc with symptom of unilateral low limb. To discuss the results of the lumbar intervertebral disc herniation with Fenestration procedure. Methods To collect clinical data of 135 patients with. protrusion of lumbar intervertebral disc with symptom of unilateral low limb underwent fenestration from February, 1990 to march, 2002 at the Department of Orthopedics, Central Hospital of Shangluo , and these patiens were followed up one year afert operation. Results 58 patients were followed up successfully. When they discharged, to some exetent their symptom had been improved. Acorrding to acessment of JOA, excellent results were obtained in 37cases (63.8%), good in 16(27.6%)and poor in 5(8.6%). The score of postoperative function when discharaged had a marked difference with that of preoperation. Conclusions The operative method has the merits of small wound and early recovery. Fenestration took not only immediate improvement of function and better effect, but aslo difinite long-term effect. Strictly grasp surgerical norm. In order to improve the curative effect, the protruded necleus pulposus of intervertebral disc should be excised and complete decompression of. nerve root is also important. To pay attention to prevent failed back surgery syndrome.