脊柱内镜下不同手术入路方法治疗腰椎间盘突出症效果.docVIP

脊柱内镜下不同手术入路方法治疗腰椎间盘突出症效果 　　[摘要] 目的 研究脊柱?染迪伦蹬约〖湎度肼泛痛?统后正中入路治疗腰椎间盘突出症的临床效果。 方法 选取湖北医药学院附属东风医院2013年8月～2015年6月收治的腰椎间盘突出症患者108例，采用随机数字法分为对照组和观察组，每组各54例。所有患者均在脊柱内镜下接受手术治疗，其中对照组患者采用传统后正中入路，观察组患者采用椎旁肌间隙入路，术后均获得随访1年，比较两组患者的手术效果及各种并发症发生率，同时比较术后不同时间腰背疼痛评分（VAS）和功能障碍指数（ODI）。 结果 观察组的手术时间、术中出血量、术后引流量及卧床休息时间均显著低于对照组（P 0.05）。 结论 脊柱内镜下椎旁肌间隙入路手术治疗腰椎间盘突出症的效果显著，可明显减少手术时间及术中出血量，且术后并发症较少，同时可明显改善疼痛及功能障碍，具有较高的疗效和安全性，值得在临床推广。 　　[关键词] 脊柱内镜；椎旁肌间隙入路；腰椎间盘突出症；临床疗效 　　[中图分类号] R687.3 [文献标识码] A [文章编号] 1673-7210（2017）03（c）-0090-05 　　Effect of different surgical approach spinal endoscopic treating lumbar disc herniation 　　ZHANG Jun1，2 YU Hualong2 LIU Yadong2 HUANG Xiaohua2 GUAN Jing3 　　1.School of Basic Medical Sciences， Wuhan University， Hubei Province， Wuhan 430071， China； 2.Department of Orthopaedics， Dongfeng Hospital Affiliated to Hubei University of Medicine， Hubei Province， Shiyan 442008， China； 3.Department of Surgery， Dongfeng Hospital Affiliated to Hubei University of Medicine， Hubei Province， Shiyan 442008， China 　　[Abstract] Objective To study clinical efficacy of endoscopic spine and paraspinal intermuscular approach after traditional posterior midline approach treating lumbar disc herniation. Methods From August 2013 to June 2015， in Dongfeng Hospital Affiliated to Hubei University of Medicine， 108 patients with lumbar disc herniation were selected and divided into the control group and the observation group by random number method. All the patients were treated with endoscopic spine surgery， the control group was treated with posterior midline approach， the observation group was treated with paraspinal intermuscular approach， all patients were followed up for 1 year after surgery， the complication rates and surgical effect index of two groups were compared， and the VAS score， disability index （ODI） at different time were also compared. Results The operation time， blood loss， postoperative drainage and bed rest time in the observation group were significantly lower than those in