小切口椎板间开窗髓核摘除术治疗腰椎间盘突出症临床分析

目的：通过评价小切口椎板间开窗髓核摘除术治疗腰椎间盘突出症的手术疗效,探讨其手术的优缺点及注意事项。方法：对96例腰椎间盘突出症患者采用小切口椎板间开窗髓核摘除术进行治疗,其中男48例,女48例;年龄16～75岁,平均46.4岁;病程1个月～30年,平均5年。采用日本骨科学会（JOA）下腰痛评分标准评价其手术后疗效。结果：所有患者均获随访,时间6个月～3.5年,平均1.2年。采用JOA下腰痛评分标准：优34例,良55例,中7例,优良率为92.71%,平均改善率为54.53%。结论：小切口椎板间开窗髓核摘除术能够取得良好的疗效,对腰椎生理结构破坏较小,发生术后腰椎不稳及腰椎术后失败综合征的可能性较低,是目前较好的腰椎间盘突出症手术治疗方式之一。

Clinical analysis in treating lumbar intervertebral disc herniation with nucleus pulposus resection through small incision and lamina fenestration

Objective: To analyze effect of treatment of lumbar intervertebral disc herniation with nucleus pulposus resection through small incision and lamina fenestration,and to explore operative advantage and mattars needing attention. Methods: Ninety-six patients with lumbar intervertebral disc herniation,including 48 males and 48 females with an average age of 46.4 years(ranging for 16-75 years) and an average course of 5 years(ranging from 1 month to 30 years),were treated with nucleus pulposus resection through small incision and lamina fenestration. The clinical effects were analyzed according to JOA scoring criteria of lower back pain. Results: All patients were followed up from 6 months to 3.5 years with an average of 1.2 years. According to JOA scoring criteria,34 cases obtained excellent result,55 good,fair 7. The rate of excellent and good was 92.71% and the mean improvement rate was 54.53%. Conclusion: Nucleus pulposus resection through small incision and lamina fenestration can obtain satisfactory outcome in treating lumbar intertebral disc herniation. The incidence of lumbar instability and postoperative complications were low. It is one of the better method for the treatment of lumbar intertebral disc herniation.