顯微內(nèi)窺鏡椎間盤(pán)切除術(shù)治療腰椎椎間盤(pán)突出術(shù)后復(fù)發(fā)

·臨床研究·

顯微內(nèi)窺鏡椎間盤(pán)切除術(shù)治療腰椎椎間盤(pán)突出術(shù)后復(fù)發(fā)

陶偉偉，洪鑫，吳小濤

作者單位：210009江蘇，東南大學(xué)附屬中大醫(yī)院骨科

通信作者：吳小濤wuxiaotao@medmail.com.cn

【摘要】目的研究后路經(jīng)椎板間隙入路顯微內(nèi)窺鏡椎間盤(pán)切除術(shù)(Micro-endoscope discectomy，MED)治療腰椎椎間盤(pán)突出術(shù)后復(fù)發(fā)的臨床療效。方法選取本院2003年6月～2013年6月診斷為腰椎椎間盤(pán)突出術(shù)后復(fù)發(fā)并行手術(shù)治療患者61例，根據(jù)治療手術(shù)方式分為觀察組和對(duì)照組。觀察組行MED手術(shù)，患者23例；對(duì)照組行后入路固定融合術(shù)，患者38例。統(tǒng)計(jì)2組術(shù)中出血量、手術(shù)時(shí)間及日本骨科學(xué)會(huì)(Japanese Orthopaedic Association，JOA)評(píng)分、疼痛視覺(jué)模擬量表(visual analogue scale, VAS)評(píng)分等情況，用SPSS 20.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果2組患者在術(shù)中出血量、手術(shù)時(shí)間方面相比，差異有統(tǒng)計(jì)學(xué)意義(P<0.05)，而術(shù)后JOA、VAS評(píng)分比較，差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。結(jié)論MED治療腰椎椎間盤(pán)突出術(shù)后復(fù)發(fā)中期臨床效果滿(mǎn)意，并將是今后脊柱外科的發(fā)展的重點(diǎn)、熱點(diǎn)。

【關(guān)鍵詞】腰椎; 椎間盤(pán)移位; 復(fù)發(fā); 內(nèi)窺鏡檢查; 椎間盤(pán)切除術(shù)

作者簡(jiǎn)介：陶偉偉(1982— )，碩士在讀，主治醫(yī)師

【中圖分類(lèi)號(hào)】R 681.533.2 【文獻(xiàn)標(biāo)志碼】 A

DOI【】

收稿日期：(2013-12-20)

Micro-endoscope discectomy for recurrent lumbar disc herniationTAOWei-wei,HONGXin,WUXiao-tao.DepartmentofOrthopaedics,ZhongdaHospital,SoutheastUniversity,Nanjing210009,Jiangsu,China

Abstract【】ObjectiveTo study the clinical efficacy of micro-endoscope discectomy (MED) in treatment of recurrent lumbar disc herniation. MethodsForm 2003 June to 2013 June, 61 cases diagnosis of recurrent lumbar disc herniation were included in the research. According to the therapeutic operation mode, divided into 2 groups. The observation group 23 cases underwent MED, and control group 38 cases underwent posterior arthrodesis fixation and fusion. The bleeding volume, operation time, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS)score were recored. Statistical analysis was performed by SPSS 20.0. Results The bleeding volume, operation time of the 2 groups had significant difference(P<0.05), but the postoperative JOA score and VAS score had no significant differences(P>0.05). ConclusionThe mid clinical effect of MED for treatment of recurrence lumbar disc herniation is satisfactory. And the technology will become hot spot and focal pointf on the development of spine surgery

【Key words】Lumbar vertebrae; Intervertebral disc displacement; Recurrence; Endoscopy; Diskectomy

J Spinal Surg, 2015,13(1):11-15

腰椎椎間盤(pán)突出癥是骨科常見(jiàn)疾病，其手術(shù)治療方案很多，包括以往的開(kāi)窗、后路半椎板切開(kāi)、全椎板減壓等方式及現(xiàn)在的經(jīng)皮穿刺臭氧治療、射頻消融治療、顯微內(nèi)窺鏡椎間盤(pán)切除術(shù)(Micro-endoscope discectomy，MED)、椎間孔鏡、后入路椎間融合術(shù)等。手術(shù)治療后都仍有復(fù)發(fā)，目前對(duì)復(fù)發(fā)治療方式的選擇上仍有較多爭(zhēng)議，本院在過(guò)去10年內(nèi)使用了MED治療椎間盤(pán)突出術(shù)后復(fù)發(fā)，效果滿(mǎn)意。現(xiàn)對(duì)10年內(nèi)病例進(jìn)行回顧性分析，現(xiàn)報(bào)道如下。……