侧卧位椎间盘切除术治疗老年高风险腰椎间盘突出症

目的探讨对老年高风险椎间盘突出症患者进行侧卧位开窗椎间盘切除手术治疗的可行性及疗效。方法 2006年4月至2010年4月间对我院17例合并心肺功能不全的老年腰椎间盘突出症患者行侧卧位小切口开窗椎间盘切除手术,观察术中生命体征、术后疗效及并发症,术前及术后3个月进行JOA评分,末次随访按Macnab标准评价疗效。结果术中及术后均未出现围手术期并发症。随访14～62（37.5±12.1）个月,术前JOA评分为6～12（9.8±1.6）,术后3个月JOA评分18～28（22.3±3.8）,与术前比较有显著差异（P〈0.01）,Macnab标准评价临床疗效优14例,良2例,可1例。结论老年高风险椎间盘突出症患者采用侧卧位开窗手术治疗可获得满意疗效。

Treatment of lumbar disc herniation in eldly high-risk patients with lumbar discectomy in lateral position

Objective To study the feasibility and clinical efficacy of lumbar discectomy in lateral position for lumbar disc herniation in eldly high-risk patients.Methods Seventeen eldly patients with lumbar disc herniation and insufficient cardiorespiratory function were underwent mini-incision lumbar discectomy in lateral position.The intra-operative life signs,post-operative efficacy and complications were observed.Japanese orthopaedic association scores（JOA scores） were used three month before and after the operation.Macnab criteria were applied to evaluate the efficacy in the last follow-up.Results No complication was found intra and post operation.The follow-up went for 14-62（37.5±12.1） months.The JOA scores before and after operation were 6-12（9.8±1.6） and 18-28（22.3±3.8） respectively,with statistical differences（P〈0.01）.According to Macnab criteria,there were 14 excellent cases,2 good cases and 1 fair case.ConclusionThe mini-incision lumbar discectomy in lateral position could achieve satisfactory short-term clinical results for eldly high-risk patients with lumbar disc herniation