椎间盘镜手术与微创小切口手术治疗腰椎间盘突出症疗效比较

目的 比较椎间盘镜手术(MED)与微创小切口腰椎间盘手术(MTD)治疗腰椎间盘突出症的早、中期疗效.方法 将166例腰椎间盘突出症患者随机分为MED组83例和MTD组83例,分别行MED和MTD手术.对术中、术后反映手术创伤的指标进行监测和观察.结果 MED组在切口长度、术中出血及术后引流量均小于MTD组(P＜0.01).两组术后血清CRP均较术前增加,但术后MED组血清C-反应蛋白增加低于MTD组(P＜0.05).两组VAS术后评分均较术前改善(P＜0.01).患者均获随访,时间2～4年.按改良Macnab疗效评定标准:MED组优65例,良11例,可5例,差2例,优良率为91.6%;MTD组优66例,良13例,可4例,差0例,优良率为95.2%.结论 腰椎间盘突出症MED手术较MTD创伤小、术后恢复快,但两种方法早、中期疗效均较满意.

Comparison of therapeutic effects between microendoscopic discectomy and microtraumtic discectomy for lumbar disc herniation

Objective To compare the therapeutic effects between microendoscopic discectomy(MED) and microtraumatic discectomy(MTD) for lumbar disc herniation.Methods All the 166 patients with lumbar disc herniation were randomly divided into two groups whom accepted MED or MTD.Parameters which could reflect the tissue invasiveness were monitored and recorded.Results Compared to the MTD,MED showed advantages,such as shorter incision,lower blood loss(P<0.01).The CRP was increased after the operation in both groups,but the increase was lower in MTD group(P<0.05).The VAS scores were decreased in both groups(P<0.01).All the 166 patients were followed up from 2 years to 4 years.According to the modified Macnab criteria,the therapeutic effects of MED was evaluated as excellent in 65 cases,good in 11 cases,fair in 5 cases,and poor in 2 cases.In the other group,the counterparts were 66,13,4,and 0 respectively.Conclusions Both operations have definite and similar therapeutic effects.Furthermore,MED is minimally invasive with fast recovery after the procedure.