| 内窥镜与开放手术治疗复发性腰椎间盘突出症的比较 |
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投稿时间：2013-05-26
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| 作者 | Author | 单位 | Address | E-Mail |
| 黄承军 |
HUANG Cheng-jun |
柳州市中医院骨二科, 广西 柳州 545001 |
The Second Department of Orthopaedics, the Liuzhou Hospital of TCM, Liuzhou 545001, Guangxi, China |
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| 唐汉武 |
TANG Han-wu |
柳州市中医院骨二科, 广西 柳州 545001 |
The Second Department of Orthopaedics, the Liuzhou Hospital of TCM, Liuzhou 545001, Guangxi, China |
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| 梁冬波 |
LIANG Dong-bo |
柳州市中医院骨二科, 广西 柳州 545001 |
The Second Department of Orthopaedics, the Liuzhou Hospital of TCM, Liuzhou 545001, Guangxi, China |
nick201@126.com |
| 娄宇明 |
LOU Yu-ming |
柳州市中医院骨二科, 广西 柳州 545001 |
The Second Department of Orthopaedics, the Liuzhou Hospital of TCM, Liuzhou 545001, Guangxi, China |
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| 关威 |
GUAN Wei |
柳州市中医院骨二科, 广西 柳州 545001 |
The Second Department of Orthopaedics, the Liuzhou Hospital of TCM, Liuzhou 545001, Guangxi, China |
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| 期刊信息：《中国骨伤》2013年，第26卷，第10期，第810-814页 |
| DOI：10.3969/j.issn.1003-0034.2013.10.004 |
| 基金项目: |
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中文摘要:
目的: 比较内窥镜手术与开放手术治疗复发性腰椎间盘突出症(RLDH)的临床效果及优缺点.
方法: 对2008年8月至2010年12月手术治疗的35例复发性腰椎间盘突出症患者进行回顾性研究. 按手术方式分为两组,内窥镜组14例,行椎间盘镜(MED)下经椎间孔减压椎间融合(TLIF);开放手术组21例,行后路全椎板减压椎间融合(PLIF).两组患者均同时采用了椎弓根螺钉内固定. 分别比较两组患者的手术时间、出血量、术后引流量、镇痛药剂量、术后卧床时间. 采用视觉模拟疼痛评分(VAS)、JOA评分(15分法)和汉化版Oswestry下腰痛功能障碍指数(CODI)对患者术前、术后及末次随访时的临床症状体征以及功能状态进行评价,对结果进行统计分析.
结果: 两组患者手术时间无差异(P>0.05),内窥镜组术中出血量、术后引流量、术后所需镇痛药剂量和卧床时间以及术后腰痛VAS评分均明显少于开放手术组(P<0.01).35例患者均获1年随访,两组患者术前术后JOA评分比较差异无统计学意义(P>0.05),内窥镜组CODI指数优于开放手术组(P<0.05).
结论: 两种术式均能获得满意的临床效果;椎间盘镜下TLIF手术创伤小、术后疼痛少、功能恢复较好,是目前治疗RLDH的首选方法. |
| 【关键词】椎间盘移位 复发 脊柱融合术 内窥镜 外科手术,微创性 |
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| Treatment of the recurrent lumbar disc herniation：a comparison between endoscopic surgery and open surgery |
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ABSTRACT
Objective: To compare the clinical effect,advantages and disadvantages of endoscopic surgery and open surgery in treating the recurrent lumbar disc herniation.
Methods: From August 2008 to December 2010,the data of 35 patients with recurrent lumbar disc herniation were retrospectively analyzed. The patients were divided into endoscopic surgery group and open surgery group according to operative methods. Fourteen patients in endoscopic surgery group were treated with the transforaminal lumbar interbody fusion by micro-endoscopic discectomy(MED) and the other 21 patients in open surgery group were treated with posterior lumbar interbody fusion by open surgery. All patients were fixed by vertebral pedicle screw. The operation time,volume of bleeding and drainage after operation,analgesic dosage and time in bed after operation were observed. Visual Analogue Scale(VAS),Japanese Orthopedic Association(JOA)and Chinese Oswestry Disability Index(CODI) were used to evaluate the clinical effects before and after operation.
Results: There was no significant difference in operation time between two groups(P>0.05). Volume of bleeding and drainage after operation,analgesic dosage and time in bed after operation,VAS score in endoscopic surgery group was less than that of open surgery group(P<0.01). All patients were followed up for 1 year. There was no significant difference in JOA between two groups(P>0.05). CODI in endoscopic surgery group was better than that of open surgery group(P<0.01).
Conclusion: Both operative methods can obtain good clinical effects,but the transforaminal lumbar interbody fusion operation by micro-endoscopic discectomy(MED) has advantage of less traumatic and less pain,better functional recovery,it is a first choice in treating the recurrent lumbar disc herniation. |
| KEY WORDS Intervertebral disk displacement Recurrence Spinal fusion Endoscopes Surgical procedures,minimally invasive |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄承军,唐汉武,梁冬波,娄宇明,关威.内窥镜与开放手术治疗复发性腰椎间盘突出症的比较[J].中国骨伤,2013,26(10):810~814 |
| 英文格式: | HUANG Cheng-jun,TANG Han-wu,LIANG Dong-bo,LOU Yu-ming,GUAN Wei.Treatment of the recurrent lumbar disc herniation：a comparison between endoscopic surgery and open surgery[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(10):810~814 |
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