经关节突入路手术治疗胸腰段椎间盘突出症.docVIP

经关节突入路手术治疗胸腰段椎间盘突出症 任 亮，孙先泽，赵正琦，胡红涛 (050011 石家庄，河北医科大学附属第三医院脊柱外科) ［摘要］目的 采用经关节突入路手术治疗胸腰段椎间盘突出症并评价其疗效。方法 本组病例包括男性7例，女性4例，年龄23～62岁，平均53岁，其中T10/11 2例，T11/12 3例，T12/L1 2例，L1/2 4例，均行侧后方经关节突入路椎间盘切除、植骨、内固定手术治疗，比较术前、术后3个月、术后1年时的JOA 评分，计算改善率，进行临床疗效评估 。结果 11例均获随访，时间为1~4年，平均2年。术前JOA评分（9.3±1.6）分，术后3个月（18.1±0.9）分，术后1年（23.7±2.1）分(P0.05)。术后1年改善率为（74.3±16.3）%。根据JOA改善率进行疗效评定，优8例，良2例，好转1例，无效0例，优良率为90.9%。结论 经关节突入路手术治疗胸腰段椎间盘突出，出血少，创伤小，对脊髓影响小，能达到完全减压的目的。 ［关键词］胸腰段；椎间盘突出；经关节突入路 [中图法分类号] [文献标志码] A [通信作者] 孙先泽，E-mail： HYPERLINK mailto163.com163.com [优先出版] HYPERLINK /kcms/detail/51.1095.R1844.003.html /kcms/detail/51.1095.R1844.003.html（2014-01-14） Transfacet process approach for the treatment of thoracolumbar disc herniation Ren Liang, Sun Xianze, Zhao Zhengqi, Hu Hongtao (Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050011, China） ［Abstract］Objective To introduce a transfacet process approach for the treatment of thoracolumbar disc herniation and evaluate the efficacy. Methods Eleven cases with thoracolumbar disc herniation were treated by this approach, including seven male cases and four female cases with an average age of 53 (from 23 to 62). Among them, 2 cases involved T10/11, 3 cases T11/12, 2 cases T12/L1, and 4 cases L1/2. Results All the patients were followed up for 1 to 4 years, with an average of 2 years. According to Otani evaluation criterion, 8 patients gained an excellent result, 2 good, 1 fair, and no bad, with the excellent and good rate of 90.9%. Conclusion The transfacet process approach is an effective method for complete decompression of thoracolumbar disc herniation, with less bleeding, tissue damage, and adverse effects on the spinal cord. ［Key words］ thoracolumbar; disc herniation; transfacet process approach Corresponding author: Sun Xianze,E-mail:163.com 胸腰段椎间盘突出引起的胸腰段前方的脊髓压迫症占椎间盘突出症的0.25%～0.75%[1]，由于其症状、体征不