显微镜下微创治疗腰椎间盘突出症的临床疗效观察

[目的]观察显微镜辅助下微创治疗腰椎间盘突出症的即时及远期疗效。[方法]2009年7月至2011年7月行显微镜下椎间盘突出髓核摘除术46例，通过术前和术后2年的影像学资料对比，并根据改良的MacNab评价标准、日本骨科协会评估治疗分数（JOA评分）、疼痛视觉模拟量表（VAS）评分评定手术的即时及远期疗效。[结果]改良的MacNab评价标准评价术后即时疗效优良率100%；腰椎神经功能JOA评分由术前的（14.5±3.8）分升至术后2年的（27.5±3.3）分，前后比较差异有统计学意义（P＜0.05），改善率为（86.7±8.9）%；VAS评分由术前（7.8±1.3）分下降至术后2年的（1.6±0.7）分，前后比较差异有统计学意义（P＜0.05），改善率为（84.5±5.7）%。术后影像学显示突出髓核摘除满意。[结论]显微镜下完成腰椎间盘突出髓核摘除术切口小，出血少，手术并发症少，其即时及远期疗效均示满意，值得临床推广。

Minimally Invasive Microscopy Surgery for Treatment of Lumbar Disc Herniation:An Observation of Clinical Effectiveness

Objective] To evaluate the current and prostecdtive efficacy of surgical treatment with microsurgical lumbar discectomy（MSLD） for lumbar disc herniation. [Methods] From July 2009 to July 2011, a retrospective study of 42 patients who had undergone MSLD was conducted. Imaging materials, Modified MacNab criteria, Japanese Orthopaedic Association（JOA） scores and the visual analog scales（VAS） scores were observed preoperatively and 1 year after operation, were used to analyze the efficiencies of the operation.[Results] The success rate（excel ent and good） was 100% according to the Modified MacNab criteria about the current efficacy. The JOA score for lumbar nerve function increased from 14.5 ±3.8 before operation to 27.5 ±3.3 after operation, with the improvement rate being （86.7 ±8.9）%; the VAS score decreased from 7.8 ±1.3 before operation to 1.6 ±0.7 after operation, with the improvement rate being （84.5 ±5.7）%; Post-operation imaging showed that the intervertebral discs were wel excised. [Conclusion]MSLD is safe and reliable, with the advantages of smal cut, less bleeding and less complication. The current and prostecdtive efficacy of surgical treatment with MSLD for lumbar disc herniation is satisfactory.