“三增加”改良胶原酶溶解术治疗巨大腰椎间盘突出症的临床应用

目的：探讨“三增加”改良胶原酶溶解术治疗巨大型腰椎间盘突出症的临床疗效。方法回顾性分析120例患者的临床资料，经 MR 或者 CT 诊断为巨大型腰椎间盘突出(突出物≥10.0 mm)，经“三增加”改良胶原酶溶解术治疗后，随访(复诊、电话等方式)3月~2年。根据患者治疗前后视觉模拟评分(VAS)按改良 MacNab 标准评定其疗效。结果120例患者治疗前 VAS 评分(6.99±0.97)分，治疗后评分(1.82±1.07)分，差异有统计学意义(P <0.05)，按改良 MacNab 标准评定其疗效：优48例，良55例，可9例，差8例。优良率85.8%，总有效率93.3%，无严重并发症发生。结论“三增加”改良胶原酶溶解术治疗巨大型腰椎间盘突出症疗效满意，可以作为该病的一种治疗选择。

Clinical value of improved collagenase chemonucleolysis in the treatment of large lumbar disc herniation

Objective To investigate the clinical value of the improved collagenase chemonucleolysis in the treatment of large lumbar disc herniation.Methods 120 cases with large lumbar disc herniation(≥10.0 mm)confirmed by MRI or CT were retrospectively analyzed.All patients were treated by the improved collagenase chemonucleolysis.A three months to two years follow-up review was conducted (visits,telephone etc.).According to the VAS scores of patients,the curative effect was assessed by modified MacNab criteria.Results 120 patients were treated by the modified collagenase chemonucleolysis.Preoperative VAS score was 6.99 ± 0.97 points,while after the operation,the VAS score was 1.82 ± 1.07 points,and the difference was statistically significant (P <0.05).According to the modified MacNab criteria,48 cases had excellent outcomes,55 cases good,9 cases fair and 8 cases poor.Conclusion The improved collagenase chemonucleolysis can be used as a treatment option for patients with large type of lumbar disc herniation.