经皮椎间孔镜椎间盘切除术与椎板开窗椎间盘切除术治疗老年腰椎间盘突出症效果观察

目的 对比分析经皮椎间孔镜椎间盘切除术与椎板开窗椎间盘切除术治疗老年腰椎间盘突出症的效果。方法 选取2013年2月至2017年1月本院骨伤科收治的98例腰椎间盘突出老年患者随机分为观察组和对照组,观察组给予经皮椎间孔镜椎间盘切除术治疗,对照组给予椎板开窗椎间盘切除术治疗,比较两组患者临床指标,术前、术后1d、1、3个月VAS评分,术前、术后1、3个月ODI、JOA评分,术后3个月疗效。结果 两组患者手术时间差异无统计学意义(P＞0.05)。观察组切口长度以及住院时间和术中出血量均低于对照组,差异有统计学意义(P＜0.05)。两组患者术前以及术后1d VAS评分无差异(P＞0.05),观察组患者在术后1个月以及术后3个月 VAS评分和ODI评分均显著低于对照组,JOA评分显著高于对照组,差异有统计学意义(P＜0.05)。术后3个月观察组患者临床疗效显著提高,优良率为93.88%,差异均具有统计学意义(P＜0.05)。结论 经皮椎间孔镜椎间盘切除术治疗老年腰椎间盘突出症可显著提高临床疗效,缓解患者疼痛,改善腰椎功能障碍,促进患者恢复,提高生活质量。

Comparison of percutaneous transforaminal discectomy and laminectomy discectomy for the treatment of lumbar disc herniation in the elderly

Objective To compare the effects of percutaneous transforaminal discectomy and laminectomy with discectomy in the treatment of lumbar disc herniation in the elderly.Methods 98 elderly patients with lumbar disc herniation admitted to our hospital from February 2013 to January 2017 were randomly divided into observation group and control group.The observation group was treated with percutaneous transforaminal discectomy,and the control group was treated with laminectomy and discectomy.The clinical indexes of the two groups were compared.The VAS scores before,1 day,1 month,and 3 months after operation,ODI and JOA scores before operation,1 month and 3 months after operation,and 3 months after operation.Results There was no significant difference in the operation time between the two groups (P＞0.05).The length of incision,hospitalization time and intraoperative blood loss were lower in the observation group than in the control group,and the difference was statistically significant (P＜0.05).There was no significant difference in VAS score between the two groups before and 1 day after operation (P＞0.05).Patients in the observation group had significantly lower VAS scores and ODI scores than the control group at 1 month after surgery and 3 months after surgery.The JOA score was significantly higher than the control group,and the difference was statistically significant (P＜0.05).The clinical efficacy of the observation group was significantly improved at 3 months after operation,and the excellent and good rate was 93.88%.The difference was statistically significant (P＜0.05).Conclusion Percutaneous transforaminal discectomy for elderly lumbar disc herniation can significantly improve clinical efficacy,relieve pain,improve lumbar dysfunction,promote recovery and improve quality of life.It is recommended to be clinically promoted.