侧后方入路手术治疗高位腰椎间盘突出症

目的探讨侧后方入路治疗高位腰椎间盘突出症(ULDH)的临床疗效。方法对20例ULDH患者行侧后方入路治疗。术前、术后2周及末次随访时进行腰痛视觉模拟评分法(VAS)及JOA评分。结果 20例全部获得随访,时间12~24(18.8±2.3)个月。VAS评分:术前为7.8分±1.3分,术后2周为1.3分±1.2分,末次随访时为1.4分±1.1分,术后2周及末次随访时与术前比较差异均有统计学意义(P0.05);JOA评分:术前为12.12分±2.12分,术后2周为20.60分±3.12分,末次随访时为21.88分±3.05分,术后2周及末次随访时与术前比较差异均有统计学意义(P0.05)。疗效按Otani et al分级方法评定:优15例,良1例,可3例,差1例,优良率为16/20。结论侧后方入路治疗ULDH疗效明确。术中应仔细操作,以避免医源性损伤。

Operative treatment of upper lumbar disc herniation through posterior-lateral approach

Objective To evaluate the clinical effect of posterior-lateral approach operation in the treatment of upper lumbar disc herniation （ULDH）, Methods A total of 20 patients of ULDH underwent posterior-lateral approach, visual analogue scale （VAS）score for lower back pain and Japanese Orthopaedic Association （JOA） score were performed preoperatively, postoperative 2 weeks and at the final follow-up. Results All patients had an follow-up period of 12 - 24（ 18. 8 ± 2.3） months. The average VAS scores of preoperation, two weeks after the operation and the fi- nal follow-up were 7. 8 ±1.3,1.3 ± 1.2 and 1. 4 ± 1.1 respectively, which was statistically significant different compared with the results of the preoperation （P 〈 0. 05） ; The average JOA scores of preoperation, two weeks after the operation and the final follow-up were 12. 12 ±2. 12,20.60 ±3, 12 and 21.88 ±3. 05 respectively, which was statistically significant different compared with the results of the preoperation （P 〈 0. 05 ）. The clinical effect of the operation was evaluated by the Otani et al classification methods： clinical outcome was excellent in 15 patients, good in 1 and fair in 3, poor in 1, with excellent and good rate of 16/20. Conclusions Surgical treatment through posterior-lateral approach is a good method for ULDH,with significant therapeutic effect. Gentle and careful operation is the key to avoid the medical injury.