摘要
目的研究经椎板间入路椎间孔镜下手术对L5/S1腰椎间盘突出症的治疗效果。方法回顾性分析2013年3月至2016年10月该院接受经椎板间入路椎间孔镜下手术治疗的82例L5/S1腰椎间盘突出症患者治疗期及随访期的相关资料,比较患者术后神经损伤、硬膜囊撕裂、椎间盘炎等并发症的发生数量及比例。记录并比较患者术前1周、术后1周、术后1个月的视觉模拟评分(VAS评分)及日本骨科协会治疗评分(JOA评分),比较患者术前1周、术后1周及术后1个月的功能障碍指数(ODI),记录患者末次随访时在Macnab疗效标准下的评定结果。结果患者术后出现神经损伤4例(4.88%),硬膜囊撕裂6例(7.32%),椎间盘炎2例(2.44%)。术前1周VAS评分为(8.41±1.72)分,JOA评分为(13.39±4.55)分;术后1周VAS评分为(2.21±1.35)分,JOA评分为(23.58±3.19)分;术后1个月VAS评分为(1.49±1.14)分,JOA评分为(24.31±3.46)分;术前1周、术后1周及术后1个月各项评分差异有统计学意义(P<0.05)。术前1周患者ODI为(54.37±14.18)%,术后1周为(23.11±4.69)%,术后1个月为(22.69±4.16)%。经改良Macnab标准对患者末次随访的疗效进行评价,疗效为优者64例(78.05%),疗效为良者16例(19.51%),疗效为可者2例(2.43%)。结论经椎板间入路椎间孔镜下手术对于L5/S1腰椎间盘突出症的治疗具有并发症少、恢复较快、疗效明显等特点,值得进行推广应用。
Objective To explore the treatment of L5/S1 lumbar intervertebral disc herniation by laminectomy via laminectomy.Methods The data of 82 patients with L5/S1 lumbar disc herniation treated by laminectomy and intervertebral foramen in our hospital from March 2013 to October 2016 were retrospectively analyzed.Comparison of postoperative neurological damage,dural sac tear,discitis and other complications of the occurrence of the number and proportion.The VAS score and JOA score were compared between 1 week,1 week after operation and 1 month after operation.The patients were followed up for 1 week,1 week after operation and 1 month after operation.The patients were recorded The results of the Macnab efficacy criteria were followed during the last follow-up.Results There were 4 cases（4.88%）of nerve injury after operation,6 cases（7.32%）of dural sac,and 2 cases（2.44%）of intervertebral discitis.The VAS score was（8.41±1.72）points,the JOA score was（13.39±4.55）points,the VAS score was（2.21±1.35）points,the JOA score was（23.58±3.19）points,the VAS score was（1.49±1.14）points after one month of operation,the JOA score was（24.31±3.46）points,1 week before surgery and 1 week after surgery and 1 month after the difference was statistically significant（P〈0.05）.The ODI index was（54.37±14.18）% at 1 week before operation,（23.11±4.69）%at 1 week and（22.69±4.16）%in 1 month.The efficacy of the modified Macnab standard was evaluated in the last followup of the patients.The results were excellent in 64 cases（78.05%）,16 cases（19.51%）with good curative effect and 2 cases（2.43%）.Conclusion The treatment of L5/S1 lumbar disc herniation with lumbar intervertebral foramen surgery has the characteristics of less complication,faster recovery and obvious curative effect,and is worthy of popularization and application.
出处
《检验医学与临床》
CAS
2017年第21期3206-3207,3210,共3页
Laboratory Medicine and Clinic
