单一和多节段腰椎间盘髓核摘除的远期疗效

观察单一节段椎间盘髓核摘除１５７例（Ａ组）和２个节段椎间盘髓核摘除５３例（Ｂ组）的近、远期疗效。２组术前临床表现、病理类型等相近似。术后５年内随访结果表明Ａ组和Ｂ组优良率分别为９１１％和８７８％（Ｐ＞００５），６～１２年随访则分别为８５１％和７５５％（Ｐ＜００５）。结果提示椎板开窗创伤小，对椎管干扰小，单一节段椎间盘髓核摘除，术后造成的腰椎失稳倾向小。半椎板切除椎管探查对椎管干扰大，术后疤痕组织形成多，多节段椎间盘髓核摘除术后造成腰椎不稳倾向大。建议对多节段椎间盘突出采用多节段开窗，对膨出椎间盘慎行摘除

Clincial Study of Single and Multilevel Discectomies in Treatment of Lumbar Disc Protrusion.

Objective:Discectomy may induce instability of lumbar spine,especially in those multilevel discectomy cases.The purpose of this study is to verify the effect of single or multilevel discectomies on long term clinical results.Methods:Between 1983 and 1993,157 patients were treated surgically with single level fenestration and discectomy (Group A),meanwhile,53 patients were treated surgically with hemilaminectomy and two level discectomies(Group B).Results:At the time of follow up for 2 5 years,123 of the 135 patients had good results(91.1%)in group A and 43 of the 49 patients had good results (87.8%) in group B,respectively.At the time of follow up for 6 12 years,108 of the 127 patients had good results(85.1%)in group A and 34 of the 45 Patients had good results(75.5%) in group B respectively.Conclusion:The present results showed single level fenestration and discectomy had less surgical trauma with better outcome in long follow up.