腰椎间盘突出症髓核摘除术远期疗效分析

目的分析腰椎间盘突出症髓核摘除术后的远期疗效。方法对240例行髓核摘除术治疗的腰椎间盘突出症患者进行10年以上随访,分析患者术后症状缓解、恢复工作情况及对手术的满意程度,并对放射学资料保存完整的患者手术前后的腰椎间隙高度和稳定性进行对比。结果优良率:开窗组为85.4%,半椎板组为79.6%,全椎板组为47.2%。术后平均恢复工作时间:开窗组为4.2个月,半椎板组为4.5个月,全椎板组为4.7个月。所有病例虽术后椎间隙高度均有不同程度的丢失,但绝大多数患者术后未出现局部不稳。结论开窗法和半椎板切除髓核摘除术治疗腰椎间盘突出症可获得良好的远期疗效。髓核摘除术后椎间隙高度下降不一定导致椎间不稳和神经根受压。

Long-term results of discectomy for lumbar disc herniation

Objective To evaluate the long-term results of discectomy for lumbar disc herniation.Methods 240 patients who underwent discectomy for lumbar disc herniation were followed up for over 10 years.Postoperative symptom alleviation,working ability and self-satisfaction of the patients were documented.A Comparative pre/post-operative radiological study was also performed to measure the postoperative height loss of involved disc spaces and to evaluate the segmental stability of lumbar spine.Results The excellent/good rate in "open-window",hemilaminectomy and total laminectomy group were 85.4%,79.6% and 47.2% respectively.The time of returning to work were 4.2 months in "open-window"group,4.5 months in hemilaminectomy group and 4.7 months in tolal laminectomy group respectively.The height loss of involved disc spaces was discovered in the postoperative radiographs in all the patients.However,no segmental instability was found in the majority of these patients.Conclusions "open-window" or hemilaminectomy may acheive satisfactory long-term results for treatment of lumbar disc herniation.No definite correlation exists between the height loss of involved disc space and segmental instability or nerve root entrapment.