显微镜下经管道与开放式腰椎间盘摘除术综合疗效对比分析

目的探讨显微镜下经管道与开放式腰椎间盘摘除术的综合疗效。方法回顾性分析2014年6月至2016年6月手术治疗的165例腰椎间盘突出症的临床资料,其中96例行显微镜下经管道腰椎间盘摘除术(观察组),60例行开放式腰椎间盘切除术(对照组)。所有病人术后平均随访(12.7±1.1)个月。采用视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评估疗效。末次随访采用Macnab标准评定术后功能。结果与对照组相比,观察组手术时间明显延长,住院时间明显缩短(P<0.05),术中出血量明显减少(P<0.05)。观察组术后并发症发生率(4.1%)与对照组(3.0%)无统计学差异(P>0.05)。两组术前VAS评分、ODI均无统计学差异(P>0.05);两组术后1周、3个月、12个月VAS评分、ODI均较术前均明显降低(P<0.05);而且,术后1周、3个月,观察组VAS评分均显著低于对照组(P<0.05)。末次随访两组Macnab功能无统计学差异(P>0.05)。结论与开放式腰椎间盘切除术比,显微镜下经管道腰椎间盘摘除术治疗腰椎间盘突出症康复快、住院时间短。

Effects of surgery on lumbar disc herniation: microscopic lumbar discectomy with tubular retractor system vs. open lumbar discectomy

Objective To investigate the curative effect of microscopic lumbar discectomy (MLD) with the tubular retractor system on lumbar disc herniation (LDH). Methods Of 156 patients with LDH undergoing surgery from June 2014, to June, 2016, 96 underwent MLD with the rubular retractor system (treatment group) and 60 underwent open lumbar discectomy (control group). All the patients were followed up for 1 year. Results The scores of mean Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) and the good rate of MacNab function were significantly better 1 year after the operation than those before the operation in both groups (P<0.05). The VAS and ODI scores were significantly lower in the treatment group than those in control group 1 week and 3 months after the operation (P<0.05). There were insignificant differences in the scores of VAS and ODI between both the group 1 year after the operation (P>0.05). The volume of intraoperative lost blood and days of hospital stay were significantly less in the treatment group than those in control group (P<0.05). Conclusion MLD with tubular retractor system is of many the advantages including minimally invasive, better curative effect, quicker postoperative recovery, and shorter hospital stays compared to the open lumbar discectomy in the patients with LDH and therefore it is worth spread.