经皮切吸治疗腰椎间盘突出症远期疗效下降原因探讨

目的　分析经皮切吸治疗腰椎间盘突出症远期疗效下降的原因 ,探讨改进措施。方法　对 34例经皮切吸治疗的病例进行分类、对比和近、远期疗效观察 ,结合CT检查了解远期病例椎管内改变。结果　该项技术治疗的腰椎间盘突出症的近期优良率 91 18% ,远期优良率下降至 70 83% ,近远期疗效有显著差异 (P <0 0 5 )。除已公认的因素外 ,还应注意 :①优先选择病程短、单纯局限性膨出的病例 ,病程大于 3年和腰椎间盘后外侧突出型不作经皮切吸的首选。②对切吸头进行技术改进 ,有利于增加切吸量。③椎管造影检查同期作切吸可以更好的指导切吸效果。结论　该项技术的指征、操作方法有待进一步规范。

Causes of Drop in Long Term Followed-up Effect of Automatic Percutaneous Lumbar Discectomy

Objective This article analyzed the causes of drop in the long term followed-up effect of automatic percutaneous lumbar discectomy(APLD) and studied its improving ways.Methods Thirty four cases of APLD were classified,contrasted and observed effect of short and long term.The spinal canal modification was shown on CT and CT myelography.Results 91.18% of the patients showed excellent and good results after APLD in a year,over a year was in 70.83%(P<0 05).The main influential factors were as follows:Over three years course of disease and posterolateral disc herniation are not the first choice for APLD.Shortly course of disease and simple lumbar disc herniation were indicated to this operation.The authors think that the modification of the appliances can be beneficial to removing nucleus pulposus(NP).The APLD was reliant on plain spine radiograph,one may add up removel NP weights.Conclusion The authors consider that selecting an appropriate method of operation and its indication need advanced standard.