髓核成形术治疗颈、腰椎间盘突出症的疗效分析

目的：探讨髓核成形术治疗颈、腰椎间盘突出症的手术技术、适应证及疗效。方法：采用ArthroCare 2000射频汽化仪对颈、腰椎间盘突出症患者实施髓核成形术。其中颈椎间盘突出症患者43例(A组)，平均年龄47岁；腰椎间盘突出症患者39例(B组)，平均年龄36岁。术前及术后随访时采用症状缓解率(VAS评分)和患者主观满意度分级进行疗效评估。结果：A组术后即刻症状缓解率平均为68％，主观满意度优良率达95％，B组术后即刻症状缓解率平均为61％，主观满意度优良率为87％。A组平均随访17．6个月，症状缓解率为49％，主观满意度优良率为63％。末次随访时B组39例中16例症状接近术前，主观满意度优良率为3l％，其中5例接受了开放手术。结论：髓核成形术创伤小、安全，治疗包含性颈椎间盘突出症疗效较好，但治疗腰椎间盘突出症疗效欠稳定。

Clinical report of nucleoplasty for treating patients with cervical and lumbar disc herniation

Objective:To explore the operative technique, best indication, clinical effect of nucleoplasty in treating disc herniation.Method:43 patients in cervical group with average age of 47 years and 39 patients in lumbar group with average age of 36 years underwent the nucleoplasty procedure by one surgeon using ArthroCare 2000 radiofrequency machine.An average percentage of symptom relief(VAS score) and subjective satisfaction were administered to measure symptoms at all patients.Result:At the time after operation,percentage of symptom relief was 68%,perfect rate of subjective satisfaction was 95% in cervical group,61% and 87% in lumbar group.17.6 months postoperatively,percentage of symptom relief was 49%,perfect rate of subjective satisfaction was 63% in cervical group,while there were recurrence in 16 cases of lumbar group postoperatively,perfect rate of subjective satisfaction 31%,5 of them accepted open surgery again.Conclusion:The preliminary results indicate nucleoplasty procedure appears to be less injury,safety and excellent efficiency for cervical disc herniation,but the curative effect was not satisfactory enough in the lumbar.