显微镜与椎间盘镜辅助腰椎间盘切除术治疗腰椎间盘突出症疗效的对比分析

目的 报道显微镜辅助直视下腰间盘切除术与椎间盘镜辅助腰间盘切除术两种不同手术方法治疗单节段腰椎间盘突出症的临床疗效.方法 比较分析显微镜与椎间盘镜辅助下的两种不同手术方法治疗单节段腰椎间盘突出症病例,治疗病例分别为33例和36例.比较手术时间、术中出血量、并发症、住院天数、术前及术后腰腿疼痛的JOAS(Japanese Orthopaedic Association Score)及VAS(Visual Analog Scales)评分、围手术期并发症等指标.结果 所有病例平均随访2年2个月(11个月至4年),2组术前及术后腰腿疼痛的JOAS及VAS评分、围手术期并发症、住院天数差异无统计学意义(P＞0.05),而在手术时间、术中出血量上差异具有统计学意义(P＜0.05).结论 显微镜辅助直视下腰间盘切除术与椎间盘镜辅助腰间盘切除术治疗单节段腰椎间盘突出症均疗效满意,均为理想的微创手术方法.

Comparison of surgical outcomes between microsurgery lumbar discectomy and microendoscopic discectomy for lumbar disc herniation

Objective To compare the surgical outcomes between microsurgery lumbar discectomy and microendoscopic discectomy for lumbar disc herniation. Methods A prospective study was conducted on the surgical procedures for lumbar disc herniation.The target of our study was a group of 33 patients who underwent surgery by microsurgery lumbar discectomy(MSLD group)and 36 patients who underwent surgery by microendoscopic discectomy(MED group).The items investigated were the operation time,amount of bleeding,duration of hospitalization,pre-and postoperative scores based on judgment criteria for treatment of lumbar spine disorders established by the Japanese Orthopaedic Association score,visual analog scales (VAS,0 to 10) for lumbago and sciatica before surgery and at discharge,perioperative complications.Results The mean duration of follow-up was 2 years and 2 months (11 months to 4 years).There were no significant differences between the 2 surgical procedures in the frequency of the pre-and postoperative Japanese Orthopaedic Association scores or postoperative VAS for lumbar pain and sciatica,operation time and duration of hospitalization. Statistically significant differences were observed in amount of bleeding and operation time,but the differences were not large, and may not have been clinically significant.Conclusion Both microsurgery lumbar discectomy and microendoscopic discectomy are appropriate for lumbar disc herniation.