单纯髓核摘除术治疗腰椎椎间盘突出症的长期疗效观察

目的回顾性观察腰椎椎间盘突出症患者行单纯髓核摘除术后的远期疗效。方法 1988年11月～2003年6月因腰椎椎间盘突出行单纯髓核摘除术且随访≥10年的患者共54例。采用中华医学会骨科学分会脊柱外科学组腰背痛手术评定标准和日本骨科学会（Japanese Orthopaedic Association,JOA）评分标准,比较不同随访时间的疗效。结果依据中华医学会骨科学分会脊柱学组腰背痛手术评定标准,54例患者总优良率为83.3%,开窗组、半椎板组和全椎板组优良率分别为83.3%、88.9%、66.7%,3组间差异无统计学意义（P〉0.05）。术前JOA评分为7.86±4.31分,术后为22.86±6.59分。3组JOA改善率分别为（71.99±28.64）%、（72.43±21.85）%、（67.02±44.68）%,3组间JOA改善率差异无统计学意义（P〉0.05）。结论单纯髓核摘除术治疗腰椎椎间盘突出症长期随访可获得良好疗效,且开窗、半椎板切除和全椎板切除疗效无明显差异。

Long-term results of discectomy for lumbar disc herniation

Objective To retrospectively analyze the long-term results of discectomy alone for patients with lumbar disc herniation.Methods A follow-up study was conducted in patients who underwent discectomy alone for lumbar disc herniation from November 1988 to June 2003 in our hospital.A total of 54 cases（male 41 and female 13） were followed up for more than 10 years.The standards Scoring System of Chinese Spinal Association（CSA） and Japan Orthopaedic Association（JOA） were used for investigation.Results According to the CSA system,the total satisfactory（good and excellent） rate of discectomy was 83.3%;the satisfactory rates of ＂open-window＂,hemilaminectomy and total laminectomy group were 83.3%,88.9%,66.7%,respectively,with no significant difference found among three groups（P0.05）.The score of JOA was 7.86±4.31 before operation and 22.86±6.59 after operation.The JOA score improvement rates of ＂open-window＂,hemilaminectomy and total laminectomy group were（71.99±28.64）%,（72.43±21.85）%,（67.02±44.68）%,respectively,and there was no significant differences among the three groups（P0.05）.Conclusion Discectomy alone can achieve satisfactory long-term results in treatment of lumbar disc herniation,and there is no significant difference in long-term results among ＂open-window＂,hemilaminectomy and total laminectomy groups.