椎间盘镜与小切口手术治疗腰椎间盘突出症的比较研究

目的比较椎间盘镜(microendoscopicdiscectomy,MED)与小切口手术治疗腰椎间盘突出症的优缺点及近期疗效。方法采用MED和小切口手术治疗腰椎间盘突出症各60例,将二者的手术疗效行统计学分析。结果MED组手术出血量、卧床时间、镇痛药使用、平均住院日情况均少于小切口手术组,而手术时间、临床症状和体征变化两组差异无显著性。按照Nakai评定标准,MED组:优76例,良20例。小切口手术组:优72例,良23例。二组优良率差异无显著性。结论MED与小切口手术治疗腰椎间盘突出症的疗效相当,各有优缺点,二者可根据具体情况选用。

Comparison of operative result of MED with limited-incision method for lumbar disc herniation

Objective] To compare the recent operative result of microendoscopic discetomy(MED) with limited-incision method for lumbar disc herniation. Methods] 60 cases of lumbar disc herniation were operated upon with MED, 60 cases of lumbar disc herniation were operated upon with limited-incision method. The operative result of two groups were compared. Results] MED had a little less bleeding, use of analgesic, mean hospital stay than limited-incision method, and there was no significant difference in operate time, change of clinical symptom and sign between two groups. But the operated indication of limited-incision method was more than MED, it can be used in all kinds of lumbar disc herniation. According to Nakai postoperative evaluation criterion, the operative result of MED was evaluated as excellent in 46 cases, good in 12 cases, the rate of excellent and good is 96.7%. the operative result of limited-incision method was evaluated as excellent in 43 cases, good in 14 cases, the rate of excellent and good is 95%. There was no significant difference between two groups. Conclusion] Limited-incision method is as an effective operation as MED for lumbar disc herniation. Which method should be used depends on each detailed case.