CAJ | 학술논문

目的：比较椎间盘镜下髓核摘除术(MED)和传统椎板开窗髓核摘除术治疗腰椎间盘突出症的临床疗效。方法对125例腰椎间盘突出症患者根据其临床表现、影像学检查及患者的选择确定手术方式,MED 组65例,传统手术组60例。对两组的切口长度、手术时间、术中出血量、术后卧床时间进行比较分析。按 JOA腰痛评分标准评估疗效。结果两组的切口长度、术中出血量、手术时间、术后卧床时间两组比较差异有统计学意义(P <0．05)。两组均顺利完成手术。术后两组 JOA 评分均较术前明显改善,差异有统计学意义(P <0．05)；两组间各时段 JOA 评分优良率比较差异无统计学意义(P >0．05)。 MED 组出现3例脑脊液漏、传统手术组2例脑脊液漏。 MED 组出现3例腰椎间盘突出复发,传统手术组1例复发。两组并发症比较差异无统计学意义(P >0．05)。结论 MED 与传统手术治疗腰椎间盘突出症均可以获得较好的临床疗效。
목적：비교추간반경하수핵적제술(MED)화전통추판개창수핵적제술치료요추간반돌출증적림상료효。방법대125례요추간반돌출증환자근거기림상표현、영상학검사급환자적선택학정수술방식,MED 조65례,전통수술조60례。대량조적절구장도、수술시간、술중출혈량、술후와상시간진행비교분석。안 JOA요통평분표준평고료효。결과량조적절구장도、술중출혈량、수술시간、술후와상시간량조비교차이유통계학의의(P <0．05)。량조균순리완성수술。술후량조 JOA 평분균교술전명현개선,차이유통계학의의(P <0．05)；량조간각시단 JOA 평분우량솔비교차이무통계학의의(P >0．05)。 MED 조출현3례뇌척액루、전통수술조2례뇌척액루。 MED 조출현3례요추간반돌출복발,전통수술조1례복발。량조병발증비교차이무통계학의의(P >0．05)。결론 MED 여전통수술치료요추간반돌출증균가이획득교호적림상료효。
Objective To compare the clinical effect of microendoscopic discectomy (MED) and open discectomy (OD) for lumbar intervertebral disc protrusion(LIDP). Methods 125 patients with lumbar disc herniation were in-cluded in the study, the surgical approach was determined in these patients with LIDP according to clinical manifesta-tions, imaging examination and the patient′s choice. 65 patients were underwent MED and 60 patients were under-went OD. The operation time,intraoperative bleeding volume,postoperative bed rest time and postoperative hospitali-zation time were compared between two groups. The clinical efficacy was assessed according to the lower back pain scoring standard of JOA. Results There was statistical difference between two groups in the length of incision, intra-operative bleeding volume and the operation time,postoperative bed rest time (P < 0. 05). Both groups were success-fully operated. The postoperative JOA score of two groups were obviously improved comparing with the preoperative JOA score (P < 0. 05). The difference of JOA score′s excellent rate was not statistically significant between two groups in each postoperative time (P > 0. 05). MED group had three cases of cerebrospinal fluid leakage, and OD group had 2 cases. MED group had three cases of recurrent lumbar disc herniation, and OD group had one case. There was no statistically significant difference between the complication rates of two groups. Conclusions MED and OD treatment for LIDP can obtain good effect.