手术治疗腰椎间盘突出症长期效果随访与评价.docVIP

手术治疗腰椎间盘突出症长期效果随访与评价 　　【摘要】 目的：分析对于腰椎间盘突出者开展椎板开窗减压髓核摘除术的远期疗效和安全性。方法：回顾性分析2014年1月-2016年8月本院收治的行椎板开窗减压髓核摘除术患者102例的临床资料，均为单节段腰椎间盘突出。术前和末次随访时分别采用JOA、ODI评分评估其疗效，不同年龄段者及不同严重程度者的疗效。结果：患者治疗优良率为83.33%（85/102），再突出者15例，平均（15.25±1.47）个月，患者术前与末次随访的ODI、JOA各项评分比较，差异均有统计学意义（P0.05）。术前与末次随访时，Ⅲ级组ODI、JOA各项评分与Ⅰ、Ⅱ级组比较，差异均有统计学意义（P0.05）。结论：单节段腰椎间盘突出者行切除病变椎板摘除髓核术的远期疗效满意，复发率小，安全性强。实施该项手术的青年患者易出现腰背痛，但持续性腿痛概率低，且重度患者的手术效果较中低度患者稍差。 　　【关键词】 腰椎间盘突出； 椎板开窗减压髓核摘除术； 术后疼痛； 生活质量； 安全性； 远期 　　【Abstract】 Objective：To analyze the long-term effect and safety of lumbar disc protrusion with laminectomy decompression discectomy.Method：The clinical data of 102 patients with Laminectomy decompression discectomy in our hospital from January 2014 to August 2016 were analyzed retrospectively，they were mono-segmental lumbar disc protrusion.JOA and ODI scores were used to evaluate the curative effect，the different age groups and patients with different severity were evaluated before and at the last follow-up.Result：The excellent and good rate of the treatment was 83.33%（85/102），and 15 cases were prominent again，average（15.25±1.47） months.Before operation and at the last follow-up，the scores of ODI and JOA in patients were compared，the differences were statistically significant（P0.05）.Before operation and at the last follow-up，the scores of ODI and JOA in Ⅲ group were compared with Ⅱ group and Ⅰ group，the differences were statistically significant（P0.05）.Conclusion：In the treatment of single segment lumbar disc herniation，the laminectomy decompression discectomy with long term results are satisfactory，with small recurrence rate and high safety.The young patients who carry out the operation are prone to low back pain，but persistent pain has low probability，and the effect of severe patients is a little worse than the middle and low degree patients. 　　【Key words】 Lumbar disc protrusion； Laminectomy decompression discectomy； Postoperative pain；Quality of life； Safety； Long-term 　　First-author’s address：Leping Second H