椎间盘镜下保留黄韧带预防术后椎管内粘连的临床研究

目的：探讨椎间盘镜下保留黄韧带预防术后椎管内瘢痕粘连的疗效。方法：140例腰椎间盘突出症病人随机分为2组分别进行微创椎间盘镜下髓核摘除术,区别在于黄韧带干预方式的不同。A：切除黄韧带组;B：保留黄韧带组。分别于术后3周、6周、1年进行随访。采用日本（JOA）标准进行评分,计算改善率,并行CT复查。结果：B组改善率较A组有显著性差异（A组与B组术后3周、6周、1年统计学t值分别为5.70、4.64、4.71;P〈0.05）,均优于A组。结论：椎间盘镜下保留黄韧带能有效的预防术后椎管内瘢痕粘连,较切除黄韧带的方法临床疗效好。

THE CLINICAL STUDY OF SPARED LIGAMENT PREVENTING THE DURA ADHERNCE IN THE SPINAL CANAL ON MICROENDOSCOPIC DISCECTOMY

Objective：To evaluate the effection of spared ligament preventing the dura adherence in the spinal canal of microendoscopic discectomy（MED）.Method：140 patients were separated mt two groups at random.Both groups were disposed with microendoscopic discectomy,differentiated from each other by flavum ligament operation.A：clear ligament;B：spared ligament.Gather materials in 3 weeks pre-operation,and 6 weeks and 1 year follow-up respectively.Theg were evaluated by the JOA（15points）,calculated the improvement ratio,CT countercheck.Result：The ratio of group B is better than group A at 3,6 weeks and 1 year（A and B：t3W=5.70、t6w=4.64、t1y=4.71.P〈0.05）.Conclusion：Spared ligamenta is an effective way of preventing the scar after the operation of disc herniation,the clinical effection is better than the method of cleared ligamenta.