MASTTM QUADRANTTM可扩张通道管系统与椎间盘镜治疗腰椎间盘突出症的临床分析

目的 分析比较采用QUADRANT可扩张通道管系统与后路椎间盘镜下髓核摘除术(microendoscopic discectomy,MED)治疗单节段腰椎间盘突出症的临床效果. 方法 对武汉大学人民医院脊柱外科2009年1月～2010年12月收治的83例单节段腰椎间盘突出症患者中45例采用QUADRANT可扩张通道管系统手术治疗,38例采用MED.比较两组病例手术时间、出血量、下地行走时间、并发症发生情况、手术前后疼痛缓解程度及术后3个月复查时疗效评价. 结果 两组术中出血量、手术时间、住院时间、并发症发生率、手术前后疼痛缓解程度及术后3个月复查时疗效评价无统计学意义差异(P＞0.05). 结论 在严格掌握手术适应证和禁忌症的前提下,QUADRANT组与MED组对于腰椎间盘突出症的治疗达到了相同的近期疗效,是一种安全、有效、操作更为容易的手术方法,但对于远期疗效仍需继续随访观察.

The Clinical Analysis of MASTTM QUADRANTTM Channel System and Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

Objective To compare and analyze the clinical effect of MASTTM QUADRANTTM channel system and microendoscopic discectomy(MED) for the treatment of lumbar disc herniation(LDH).Methods Between January 2009 and December 2010,83 patients with single LDH were surgically treated in the department of spine surgery,People’s Hospital of Wuhan University.Among them,45 patients underwent minimally invasive windowing decompression assisted by Mast Quatrant system,and the other 38 patients underwent MED.The operation time,blood loss,ambulation time,complications,postoperative pain relief and the efficacy evaluation after 3 months of the two groups were compared.Result The blood loss,the time of operation and hospital stay,the pain relief and the efficacy evaluation three months after operation had no significant difference between the two groups(P>0.05).Conclusions Under the premise of mastering the indications and contraindications,MASTTM QUADRANTTM has the same short-term effects with MED on treatment of LDH.It is a safe,effective and simple operation.However,the long-term prognostic benefits need to be confirmed by further follow-up.