低温等离子髓核成形术治疗腰椎间盘突出症

目的：探讨经皮穿刺低温等离子髓核成形术治疗腰椎间盘突出症的有效性及其特点。方法：本组93例住院患者采用ArthroCareSystem2000等离子体手术系统进行治疗,对短期疗效进行随访观察。设立对照组对治疗效果进行比较分析,其中保守治疗对照组100例,开放手术对照组50例。结果：微创组患者中,单节段突出67例,多节段36例。神经受累定位L3～4节段1例,L4～5节段65例,L5～S1节段17例。手术部位为1间隙79例,2间隙14例,共计107个椎间盘。平均随访时间20.5个月,好转率为69.7%。保守组好转率为66.5%,手术组好转率为65.1%。微创组的手术时间、住院日等指标少于对照组,未出现神经血管损伤和手术后感染等并发症。结论：经皮穿刺低温等离子髓核成形术治疗腰椎间盘突出症有效,与其他方法相比,具有操作简单、安全快速、住院时间短等特点。

Percutaneous nucleoplasty in the treatment of the patients with lumbar disc herniation

Objective:To evaluate the efficacy of percutaneous nucleoplasty in the patients with lumbar disc herniation. Methods:From March 2003 to February 2006, the study group 93 patients with lumbar disc herniation were treated with nucleoplasty coblation(ArthroCare System 2000, USA.). The control group one was 100 patients with non-operation and control group two was 50 patients with open surgery. Results:107 levels were treated with nucleoplasty. The average clinical recovery rate for all 93 patients, the control group one with non-operation,the control group two with operation were 69.7%,66.5% and 65.1% respectively, mean follow-up time was 20.5 months. The operation time and hospitalization days in minimally invasive group were shorter than those in the control group.No complication of neural or vascular injury or postoperative infection and etc were found. Conclusion:Our data indicate that precutaneous nucleoplasty has been found to be an effective,rapid and safe procedure for lumbar disc herniation.