改良微创Love手术治疗腰椎间盘突出症的远期疗效分析

目的 探讨改良微创Love手术治疗腰椎间盘突出症的远期疗效.方法 1995年1月至2000年12月共373例腰椎间盘突出症患者接受改良微创Love手术治疗,其中男性250例,女性123例,年龄11～77岁,平均年龄45.0岁.所有患者均以坐骨神经痛为主诉,部分伴有腰痛.病变部位:L3,4 11例,L4,5 159例,L5-S1 195例,L4,5及L5-S1同时病变8例.结果 平均手术时间65 min,平均术中出血量22ml,手术切口平均长3.2 cm.截至2005年9月,317例患者获得随访,随访率85.0%;随访时间5年6个月～10年5个月,平均7年8个月.135例患者接受椎间盘造影检查,按照改良的Roland-Morris功能障碍评分系统:优198例,良68例,中51例,优良率84.0%.10例(3.2%)手术椎间盘突出复发;其中7例接受内固定术,1例选择保守治疗.1例出现腰椎滑脱.结论 改良微创Love术远期疗效肯定,可作为腰椎间盘突出症手术治疗的首选方法.

The long-term evaluation of treatment for the lumbar disc herniation with the modified Love operation

Objective To explore the long-term outcome of lumbar disc herniation(LDH)after the treatment with modified mini-invasive Love operation. Methods From January 1995 to December 2000,373 patients suffered from LDH underwent the modified mini-invasive Love operation.There were 250 male and 123 female patients aged from 11 to 77 years old(with a mean of 45.0 years old).Most patients complained of sciatica accompanying back pain. The lesion level included L3,4 in 11 patients,L4,5 in 159 patients,L5-S1 in 195 patients and L4,5 combined with L5-S1 in 8 patients.Results The average operative duration was 65 min. The average blood lose was 22 ml.The average incision length was 3.2 cm.Till September 2005,317patients were available at the final follow-up during the period from 5 years and a half to 10 years and 5 months.The average duration of follow-up was 7 years and 8 months.A total of 135 pailents underwent the CT discogram.According to the modified Roland-Morris Dysfunction Questionnaire,198 patients were rated as excellent,68 as good,and 51 as fair.The excellent rate was 84.0%.The scores for young patients were higher than senile patients.Herniation recurrence occurred in 10 patients(3.2%),in which 7 patients underwent the operation of internal fixation and 1 patient preferred the conservative treatment. One patient got the spondylolisthesis.Conclusions The long-term outcome of the modified mini-invasive Love operation is effective.It is a good choice for the LDH patients.