半椎板切除髓核摘除术与椎板开窗髓核摘除术治疗腰椎间盘突出症的远期疗效比较

目的比较半椎板切除髓核摘除术与椎板开窗髓核摘除术治疗腰椎间盘突出症的远期疗效。方法选取我院2006年8月至2010年4月收治的80例腰椎间盘突出症患者为研究对象,采用信封法分为Ⅰ组(40例,半椎板切除髓核摘除术)和Ⅱ组(40例,椎板开窗髓核摘除术)。比较两组的ODI、SF-MPQ、腰部活动障碍评分量表评分、临床病情控制优良率及随访10年的复发率。结果随访5、10年,Ⅱ组的ODI、SF-MPQ、腰部活动障碍评分量表评分均明显低于Ⅰ组,Ⅱ组的临床病情控制优良率明显高于Ⅰ组(P<0.05)。随访10年,Ⅱ组的复发率明显低于Ⅰ组(P<0.05)。结论椎板开窗髓核摘除术治疗腰椎间盘突出症的远期效果显著,能更有效地改善腰椎功能,提升腰部活动能力,减轻疼痛,降低复发率。

Comparison of long-term efficacy of semilaminectomy and nucleus pulposus removal and fenestration of vertebral lamina and enucleation of nucleus pulposus in the treatment of lumbar disc herniation

Objective To compare the long-term efficacy of semilaminectomy and nucleus pulposus removal and fenestration of vertebral lamina and enucleation of nucleus pulposus in the treatment of lumbar disc herniation.Methods A total of 80 patients with lumbar disc herniation admitted in our hospital from August 2006 to April 2010 were selected as the research objects,and the patients were divided into groupⅠ(40 cases,semilaminectomy and nucleus pulposus removal)and groupⅡ(40 cases,fenestration of vertebral lamina and enucleation of nucleus pulposus)using the envelope method.The scores of ODI,SF-MPQ,lumbar motility disorder scale,the excellent and good rate of clinical disease control and the recurrence rate of 10-year follow-up were compared between the two groups.Results Followed for 5 and 10 years,the scores of ODI,SF-MPQ and lumbar motility disorder scale in the groupⅡwere significantly lower than those in the groupⅠ,and the excellent and good rate of clinical disease control in the groupⅡwas significantly higher than that in the groupⅠ(P<0.05).After 10-year follow-up,the recurrence rate in the groupⅡwas significantly lower than that in the groupⅠ(P<0.05).Conclusion Fenestration of vertebral lamina and enucleation of nucleus pulposus in the treatment of lumbar disc herniation has significant long-term effect,it can more effectively improve the lumbar function,enhance the lumbar activity ability,relieve pain and reduce the recurrence rate.