非包含性腰椎间盘突出患者不同介入治疗方法的选择*

背景：非包含性腰椎间盘突出是临床常见类型之一,是保守治疗及一些微创介入手段效果不佳的主要原因,如何提高非包含性腰椎间盘突出的治疗效果是介入治疗的主要方向。目的：比较3种不同介入治疗方法对非包含性突出的疗效,探索提高治疗非包含性突出疗效的方法。方法：选择介入治疗的符合单纯非包含性腰椎间盘突出的患者共174例,其中66例患者行钳取法经皮腰椎间盘切除,52例行盘内及盘外化学溶核,两种方法相结合的双介入疗法56例。结果与结论：3组患者均经过连续6个月随访,双介入方法的优良率明显高于其他两种方法(P < 0.05),不适发生率明显低于其他两种方法,说明双介入法可提高治疗的优良率,减少治疗后不适发生率,在技术上无明显增加难度,是一项安全有效的治疗方法。

Interventional therapy selection for treatment of noncontained lumbar intervertebral disc herniation

BACKGROUND: Noncontained lumbar intervertebral disc herniation is a common type in clinic. It is also the primary cause of failure in the conservative and microinvasive-interventional treatments. How to improve the treatment effect is the main point in the research of noncontained lumbar intervertebral disc herniation.OBJECTIVE: To compare the effects among three interventional therapies in treating noncontained lumbar intervertebral disc herniation and explore how to improve the treatment effect of noncontained lumbar intervertebral disc herniation.METHODS: A total of 174 cases of noncontained lumbar intervertebral disc herniation with various interventional treatments were involved. Percutaneous lumbar discectomy with forceps was performed in 66 cases, chemonucleolysis was performed in 52 cases, and double interventional therapy (DIT) of the above two methods was performed in 56 cases. RESULTS AND CONCLUSION: After follow-up of 6 months, the excellent and good rate in the DIT group was significantly higher than those of the percutaneous lumbar discectomy group and chemonucleolysis group (P < 0.05). The uncomfortable rate in the DIT group was significantly lower than other groups. It is suggested that DIT could improve the excellent and good rate and reduce the uncomfortable rate in treating noncontained lumbar intervertebral disc herniation. DIT is an effective and safe method in treating noncontained lumbar intervertebral disc herniation without obvious increased difficulty.