摘要
目的观察3种手术治疗腰椎间盘突出症的中期临床疗效。方法回顾性分析2010年1月-2014年2月陕西省咸阳市中心医院脊柱外科腰椎间盘突出症患者162例的临床资料,其中微创手术54例(微创组),单纯髓核摘除术52例(单纯组),椎间植骨融合+内固定手术56例(融合组)。统计手术时间、术中出血量、住院时间、住院费用,进行腰椎JOA功能评分、改良MacNab疗效评价,计算复发率评价临床治疗效果。结果 2组患者手术时间、术中出血量、住院时间及住院费用比较,微创组明显优于其他2组(F/P=6.114. 000/<0. 001、308. 000/<0. 001、929.300/<0.001、48 895.000/<0.001)。3组患者入院时、出院时及末次随访时的JOA评分比较差异无统计学意义(P> 0.05);临床疗效MacNab评价,微创组优良率优于单纯组及融合组(χ~2/P=10.006/0.007);术后复发率微创组分别高于单纯组和融合组(χ~2/P=4.397/0.036、4.010/0.045)。结论腰椎间盘突出症的手术治疗,微创手术中期疗效好,但复发率高,临床要综合考虑应用合适的手术方式。
Objective To observe the mid-term clinical efficacy of three kinds of surgical treatment for lumbar disc herniation. Methods Retrospective analysis of 162 cases of lumbar disc herniation in the spine surgery of Xianyang Central Hospital from January 2010 to February 2014,including 54 cases of minimally invasive surgery (minimally invasive surgery) and 52 cases of simple nucleus pulposus removal (simple group),interbody fusion with internal fixation and internal fixation in 56 cases (fusion group). The operation time,intraoperative blood loss,hospitalization time,hospitalization cost,lumbar spine JOA function score,modified MacNab efficacy evaluation,and recurrence rate were evaluated. Results The operation time,intraoperative blood loss,hospitalization time and hospitalization cost of the two groups were significantly better in the minimally invasive group than in the other two groups ( F/P =6 114.000/<0.001, F/P =308.000/<0.001, F/P = 929.300 /<0.001, F / P =48895.000/<0.001). There was no significant difference in JOA scores between the three groups at the time of admission,at the time of discharge,and at the last follow-up ( P >0.05). The clinical efficacy of MacNab was better than that of the simple group and the fusion group (χ^2/ P =10.006/0.007);The postoperative recurrence rate was higher in the minimally invasive group than in the simple group and the fusion group (χ^2/ P = 4.397/0.036,χ^2/ P =4.010/0.045). Conclusion Surgical treatment of lumbar disc herniation,minimally invasive surgery in the mid-term effect,but the recurrence rate is high,the clinical should consider the application of appropriate surgical methods.
作者
郭团茂
行艳丽
曹伟宁
马航
朱海云
杨兰
GUO Tuanmao;XING Yanli;CAO Weining;MA Hang;ZHU Haiyun;YANG Lan(Department of Orthopaedics,Xianyang Central Hospital,Xianyang 712000,China)
出处
《疑难病杂志》
CAS
2019年第2期175-178,共4页
Chinese Journal of Difficult and Complicated Cases
基金
陕西省科技厅面上项目(2014JM4115)
陕西省卫生计生委项目(2016D071)
咸阳市科技局课题(2016K02-99)
咸阳市科技创新团队基金资助[咸科领办(2014)8号]
关键词
腰椎间盘突出症
微创手术
单纯髓核摘除术
椎间植骨融合内固定术
Lumbar disc herniation
Minimally invasive operation
Discectomy decompression
Spinal fusion and internal fixation
