经Wiltse入路Quadrant通道下椎间盘切除术并纤维环修复术治疗单节段腰椎椎间盘突出症

目的 探讨经Wiltse入路Quadrant通道下椎间盘切除术并纤维环修复术治疗单节段腰椎椎间盘突出症(LDH)的临床疗效.方法 2016年1月—2018年9月收治单节段LDH患者82例,其中采用经Wiltse入路Quadrant通道下椎间盘切除术治疗47例(对照组),采用经Wiltse入路Quadrant通道下椎间盘...

Wiltse approach discectomy under Quadrant channel and annulus fibrosus repair for treatment of single-segment lumbar disc herniation

Objective To investigate the clinical efficacy of Wiltse approach discectomy under Quadrant channel and annulus fibrosus repair for the treatment of single-segment lumbar disc herniation(LDH). Methods From January 2016 to September 2018,82 patients with single-segment LDH were treated,including 47 cases treated with Wiltse approach discectomy under Quadrant channel(control group) and 35 with Wiltse approach discectomy under Quadrant channel and annulus fibrosus repair(repair group). The operation time,intraoperative blood loss,visual analogue scale(VAS) score of low back and leg pain,Oswestry disability index(ODI) and the intervertebral space height of the operation segment before and after operation were recorded. Pfirrmann grade were recorded before operation and at the final follow-up. The recurrence and reoperation conditions of the 2 groups were observed,and the recurrence time was recorded. Results All the operations were successfully completed. All the patients were followed up for more than 24 months. There was no significant difference in operation time and intraoperative blood loss between the 2 groups(P>0.05). The VAS score of low back and leg pain and ODI of the 2 groups at each time point after operation were significantly improved compared with those before operation,all with a statistical significance(P<0.05);and there was no significant difference between the 2 groups at each time point(P>0.05). At the final follow-up,the intervertebral space height of the operation segment in the control group was reduced by 14.66%,and repair group reduced by 12.54%,and there was no significant difference between the 2 groups(P>0.05). At the final follow-up,there was no aggravation of intervertebral disc degeneration in both groups. In the control group,4 patients recurred in the same segment,and the recurrence rate was 8.51%,and the mean recurrence time was 12.6 months;3 patients underwent reoperation,and the reoperation rate was 6.38%,and the mean reoperation time was 14.2 months. There was no recurrence and reoperation case in the repair group. Conclusions It is safe and effective to treat single segment LDH with Wiltse approach discectomy under Quadrant channel and annulus fibrosus repair. On the basis of strictly following the indications and standard operation,it can effectively reduce the risk of postoperative recurrence and reoperation.