CAJ | 학술논문

　　目的探讨微创小切口椎间盘切除术（M TD）治疗腰椎间盘突出症的远期疗效。方法对86例M TD治疗的腰椎间盘突出患者进行为期5年的随访。分析其日本骨科学会评估治疗（JOA）评分及疗效维持情况。结果术前JOA总评分平均为（6．2±1．8）分，术后6个月、1年、2年及5年分别升至（23．1±5．8）分、（24．8±4．2）分、（24．9±4．3）分、（24．5±4．6）分，均较术前显著升高，差异有统计学意义（P＜0．01）；并且术后1年、2年及5年JOA评分稳定。JOA症状改善率为优的有48例（85．7％），良6例（10．7％），中及差各1例（1．8％），且长期随访发现疗效稳定。结论M TD治疗腰椎间盘突出症患者长期疗效显著并稳固，在准确定位并熟练掌握操作要领的基础上，适合于各级医院开展。
　　목적탐토미창소절구추간반절제술（M TD）치료요추간반돌출증적원기료효。방법대86례M TD치료적요추간반돌출환자진행위기5년적수방。분석기일본골과학회평고치료（JOA）평분급료효유지정황。결과술전JOA총평분평균위（6．2±1．8）분，술후6개월、1년、2년급5년분별승지（23．1±5．8）분、（24．8±4．2）분、（24．9±4．3）분、（24．5±4．6）분，균교술전현저승고，차이유통계학의의（P＜0．01）；병차술후1년、2년급5년JOA평분은정。JOA증상개선솔위우적유48례（85．7％），량6례（10．7％），중급차각1례（1．8％），차장기수방발현료효은정。결론M TD치료요추간반돌출증환자장기료효현저병은고，재준학정위병숙련장악조작요령적기출상，괄합우각급의원개전。
Objective To explore the long-term effect of microtraumtic discectomy (M TA) in the treatment of lumbar disc herniation disease .Methods 86 patients with lubar intervertebral disc protrusion arranged M TD were followed up for 5 years ,The Japanese orthopaedic society assessment of treatment (JOA) score and maintained cura-tive effects were analyzed .Results The symptom score was increased until 6 months(23 .1 ± 5 .8) ,1 year (24 .8 ± 4 .2) ,2 years (24 .9 ± 4 .3) and 5 years (24 .5 ± 4 .6) after operation compared to preoperation (6 .2 ± 1 .8) (P<0 . 01) .Symptom improvement rate of JOA for optimal had 48 cases (85 .7% ) ,benign in 6 cases (10 .7% ) ,and poor in 1 case (1 .8% ) Long-term follow-up indicated that curative effect was stable .Conclusion M TD in patients with lum-bar disc herniation could be with significant long-term efficacy and stableness ,and could be carried out at all levels of hospitals on the basis of accurate positioning and skilled in operating essentials .