显微内镜椎间盘切除术治疗巨大腰椎间盘 突出症的疗效研究

Comparison between the micro-endoscopic discectomy and conventional open surgery in large lumbar discherniation treatment

摘要:

目的 探讨应用后路显微内镜椎间盘切除系统（MED）治疗巨大型椎间盘突出症的临床疗效并分析总结术中术后的注意事项。 方法 对2002年6月-200年12月该院诊治的126例单间隙、巨大腰椎间盘突出症患者进行回顾分析，其中65例应用MED系统微创治疗（MED组），61例采用常规开放手术治疗（OPEN组），并从术中出血、并发症发生率、治疗费用、术后疗效和住院时间等方面进行比较分析。 结果 两组病例均获随访12个月以上，两组在术中出血量、并发症发生率和术后疗效等方面上差异无显著性（P >0.05），在治疗费用MED组（8，885±126）元，略低于OPEN组（9，422±251）元（P <0.05），而住院时间MED组（9.5±2.3）d明显少于OPEN组（14.3±3.6）（P <0.01）。 结论 MED治疗巨大型椎间盘突出症具有创伤小、术后脊柱结构稳定及术后近期临床疗效可靠等特点，值得临床医师合理应用，但其远期疗效如何还需尚需长期的随访研究。

Abstract:

【Objective】 To investigate the clinical effect of micro-endoscopic discectomy (MED) in large lumbar discherniation treatment and analyze the advantage of this method. 【Methods】 Totally 126 large lumbar discherniation patients were investigated,including 65 patients treated with MED and 61 patients treated with conventional open surgery(OPEN). The clinical results: the blood loss in operation, the complication rate, the cost of treatment and the average hospital time were evaluated . 【Results】 Two groups of patients were followed up for 12 months or more. The operation blood loss, complication rate, postoperative effects were no significant difference between the two groups (P >0.05), but the group of MED had shorter average hospital time with the group of OPEN (9.5±2.3 VS. 14.3±3.6) (P <0.01), and less cost of treatment than that of the group of OPEN (P <0.05). 【Conclusion】 Compared with conventional open surgery group, MED is of smaller incision,less tissue trauma and quicker recovery,which can obtain the best clinical result and should be selected in large lumbar discherniation treatment.