摘要
目的 评价显微内窥镜腰椎间盘髓核摘除术 (MED)的临床疗效。方法 39例腰椎间盘突出手术患者 ,MED组 2 3例 ,开窗手术组 16例 ,术后来院复诊 ,患者填写问卷调查表 ,医生检查患者后填写腰痛疾患评诂表 ,行MRI检查并测量椎间盘突出物的大小 ,比较MED组与开窗手术组的临床效果。结果 随访时间平均为 11个月 (3～ 19个月 )。与开窗手术组比较 ,MED组手术创伤小、术中失血量较少 ;平均住院时间较短 (P <0 0 5 )。两组患者的恢复工作时间和客观临床改善率相似 (P>0 0 5 ) ,术后总体改善率MED组为 70 2 %、开窗手术组为 70 6 %。但MED组患者主观满意率(73 9% )低于开窗手术组 (93 8% ) (P <0 0 5 )。两组间MRI的改变相似 ,术后突出物难以完全消失 ,但突出物变小。结论 MED是一种微创技术 ,临床疗效与椎板间开窗手术相近 ;随访期间 。
Objective To evaluate microendoscopic discectomy(MED) procedure for treatment of lumbar disc herniation. Methods 39 cases were evaluated. 23 cases were undergone with MED, 16 interlaminal fenestration approach discectomy (IFAD). A Patient Self evaluation Questionnaires and an Evaluation Criteria of Lumbar Disorder given by surgeon were used. The patients were also examined with MRI and the size of the herniated discs was measured. The outcome of MED was compared with that of IFAD. Results All cases were followed up for 3 to 19 months (average 11 months). The surgical trauma and the blood loss were less and the average length of hospital stay was shorter in MED group ( P <0 05). The mean time of returning to work and the ratio of improvement measured objectively in MED group were the same as those of IFAD group(70 2% in MED group, 70 6% in IFAD group ( P >0 05). But the ratio of the patients' subjective satisfaction in MED group(73 9%) was significantly lower than that in the IFAD group(93 8%)( P <0 05). The evaluation of the MRI from pre operation to post operation in the MED group was the same as that in the IFAD group. The size of the herniated disc significantly decreased ( P <0 05) but it didnt disappear completely. Conclusion The MED procedure is a minimal invasive technique and can give the same results as IFAD. The herniated disc tends to decrease but not disappear during follow up period.
出处
《临床骨科杂志》
2003年第2期159-161,共3页
Journal of Clinical Orthopaedics
