开放椎板开窗术与后路椎间盘镜髓核摘除术治疗腰椎间盘突出症疗效比较

目的比较开放椎板开窗术(OD)与后路椎间盘镜髓核摘除术(MED)治疗腰椎间盘突出症(LIDP)的临床疗效。方法 57例LIDP患者根据手术方式不同分为OD组31例和MED组26例,对2组患者手术时间、术中出血量、术后卧床时间、术后住院时间及临床疗效进行比较。结果 2组患者手术时间比较差异无统计学意义(P>0.05);MED组患者术中出血量显著少于OD组(P<0.05),术后卧床时间及术后住院时间显著短于OD组(P<0.01)。根据Nakia判定标准,OD组优20例,良7例,可4例,优良率87.1%;MED组优19例,良5例,可2例,优良率92.3%;2组患者临床疗效比较差异无统计学意义(P>0.05)。结论 OD与MED治疗LIDP均可以获得较好的临床疗效,但MED具有创伤小、出血少、患者恢复快、住院时间短等优点。

Comparison of curative effect of open discectomy and microendoscopic discectomy for lubar intervertebral disc protrusion

Objective To compare the clinical effect of open discectomy(OD) and microendoscopic discectomy(MED) for lubar intervertebral disc protrusion(LIDP). Methods Fifty-seven patients with LIDP were divided into OD group(n=31) and MED group(n=26) according to different operation method.The operation time,intraoperative bleeding volume,postoperative bed rest time,postoperative hospitalization time and clinical effect were compared between two groups. Results There was no statistical difference in the operation time between two groups(P>0.05).Compared with OD group,the intraoperative bleeding volume was significantly less(P<0.05),moreover,the postoperative bed rest time,postoperative hospitalization time were significantly shorter in MED group(P<0.01).According to Nakia standard,in OD group,excellent in twenty cases,good in seven cases,fair in two cases,the excellent and good rate was 87.1%;in MED group,excellent in nineteen cases,good in five cases,fair in two cases,the excellent and good rate was 92.3%;there was no statistical difference in the clinical effect between two groups(P>0.05). Conclusion OD and MED treatment for LIDP can obtain better effect,but MED treatment for LIDP has good quality of less operation,less bleeding,faster recovery and shorter hospital stay.