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后路小切口椎板间开窗术治疗巨大型腰椎间盘突出
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作者Author单位UnitE-Mail
魏美钢 WEI Mei-gang 河南省直第三人民医院骨科,河南 郑州 450006 Department of Orthopaedics,The 3rd People's Hospital of Henan Province,Zhengzhou 450006,Henan,China weimg1998@hotmail.com 
贺毅 HE Yi 河南省直第三人民医院骨科,河南 郑州 450006 Department of Orthopaedics,The 3rd People's Hospital of Henan Province,Zhengzhou 450006,Henan,China  
王必胜 WANG Bi-sheng 河南省直第三人民医院骨科,河南 郑州 450006 Department of Orthopaedics,The 3rd People's Hospital of Henan Province,Zhengzhou 450006,Henan,China  
赵滨 ZHAO Bin 河南省直第三人民医院骨科,河南 郑州 450006 Department of Orthopaedics,The 3rd People's Hospital of Henan Province,Zhengzhou 450006,Henan,China  
期刊信息:《中国骨伤》2010年23卷,第6期,第456-458页
DOI:10.3969/j.issn.1003-0034.2010.06.020


目的:探讨后路小切口椎板间开窗治疗巨大型腰椎间盘突出的手术方法及治疗效果。

方法: 对1999年至2008年收治的107例巨大型腰椎间突出症患者进行回顾性分析,男78例,女29例;年龄26~59岁,平均38.5岁。病变部位:L4,5椎间盘突出36例,L5S1椎间盘突出71例,椎间隙髓核突出率均大于40%。所有患者均施行后路小切口椎板间开窗髓核摘除术。依据改良JOA腰背痛评分表从自觉症状(包括腰痛、下肢疼痛或麻木、步行能力)和体格检查(包括直腿抬高试验、感觉、肌力)进行评分,并比较术前术后JOA评分的差异。

结果:107例均获随访,时间0.5~4年,平均1.75年。手术后JOA评分中的各项评分均优于术前。术前JOA评分为(1.500±1.200)分;术后JOA评分为(12.700±0.950)分;差异具有统计学意义(P<0.001),术后改善率为(82.96±6.85)%。

结论:后路小切口椎板间开窗摘除髓核术是治疗巨大型腰椎间盘突出症的可靠方法,创伤小,术后脊柱稳定性好,有利于患者的恢复及疗效的维持。
[关键词]:椎间盘移位  腰椎  外科手术  椎间盘切除术
 
Mini-incision posterior laminectomy by fenestration in the treatment of huge lumbar disc herniation
Abstract:

Objective: To discuss clinical effects and methods of mini-incision posterior laminectomy by fenestration in the treatment of huge lumbar disc herniation.

Methods: From 1999 to 2008,107 patients with huge protruded lumbar intervertebral disc were retrospectively analyzed including 78 males and 29 females with an average age of 38.5 years ranging from 26 to 59 years. The patients were operated with mini-incision posterior laminectomy by fenestration. The affected region of patients were L4,5(36 cases),L5S1(71 cases). The herniation rate of nucleus was more than 40%. The patient's scores based on low back pain improved JOA standard were retrospectively analyzed.

Results: The 107 patients were followed-up for from 0.5 to 4 years with an average of 1.75 years. The scores by low back pain improved JOA standard were improved from (1.500±1.200)before operation to (12.700±0.950) after operation. The average improvement rate was(82.96±6.85)%.

Conclusion: It is a reliable method in the treatment of huge lumbar disc herniation with mini-incision posterior laminectomy by fenestration. The treatment method have advantage with less trauma,good spinal stability,conducive to patient recovery and maintain clinical efficacy.
KEYWORDS:Intervertebral disk displacement  Lumbar vertebrae  Surgical procedures,operative  Discectomy
 
引用本文,请按以下格式著录参考文献:
中文格式:魏美钢,贺毅,王必胜,赵滨.后路小切口椎板间开窗术治疗巨大型腰椎间盘突出[J].中国骨伤,2010,23(6):456~458
英文格式:WEI Mei-gang,HE Yi,WANG Bi-sheng,ZHAO Bin.Mini-incision posterior laminectomy by fenestration in the treatment of huge lumbar disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(6):456~458
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