文章摘要
王若飞刘洪涛△ 吕宏琳刘晓阳李广润.微创髓核摘除术治疗高龄腰椎间盘突出症的临床研究[J].,2014,14(5):908-910
微创髓核摘除术治疗高龄腰椎间盘突出症的临床研究
Research on the Clinical Efficacy of Minimally Nucleus Pulposus Prolapsein the Elderly Patients with Lumbar disc Herniation
  
DOI:
中文关键词: 腰椎间盘突出症  微创髓核摘除术  椎弓根钉固定  椎间融合  临床疗效
英文关键词: Lumbar disc herniation  Minimally invasive surgery  Pedicle screw fixed  Intervertebral fusion  Clinical effect
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作者单位
王若飞刘洪涛△ 吕宏琳刘晓阳李广润 青岛大学医学院附属烟台毓璜顶医院 
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中文摘要:
      摘要目的:探讨微创髓核摘除术治疗高龄腰椎间盘突出症的临床疗效。方法:收集2007 年3 月~2012 年3 月本科室收治的老年 腰椎间盘突出症患者40例(年龄>65 岁,排除腰椎不稳),随机分为实验组和对照组,每组20 例,其中实验组患者行微创Quadrant 通道下髓核摘除术,对照组患者行腰椎后路椎管减压椎间盘摘除植骨融合内固定术。比较两组手术时间、切口长度、出血量、手术 效果、椎间隙平均高度丢失量及腰椎平均前凸角改变等指标的差异。结果:实验组患者的手术时间、切口长度、出血量及术后3天 VAS 疼痛目测评分均明显低于对照组(P<0.01)。腰椎平均前凸角改变显著小于对照组(P<0.05)。实验组和对照组术后6 个月改 良MacNab 分级优良率均为90%(P>0.05),实验组术后2 年椎间隙高度平均丢失量与对照组无明显差异(P>0.05)。结论:相对腰 椎后路椎管减压椎间盘摘除植骨融合内固定术而言,单纯微创髓核摘除术治疗高龄腰椎间盘突出症时具有手术时间短、出血少、 创伤小的优势。
英文摘要:
      ABSTRACT Objective:To investigate the clinical effect of minimally nucleus pulposus prolapse in the elderly patients with lumbar disc herniation. Methods:40 elderly patients who were over 65 years old with Lumber Disc Herniation (LDH) hospitalized from March 2007 to March 2012(lumbar instability patients were excluded) were selected and randomly divided into the experimental group and control group (20 cases in each group). The experimental group was treated with the QUADRANT, and the control group was treated with whole vertebral plate rejected, the internal fixation was used for comparison. The VAS score three days after surgery, MacNab grading, operation time, blade length, blood loss, Vertebra gap height and the Average Cobb's Angle were compared. Results:The operation time and blade length of experimental group were shorter than those of the control group, so were the bleed loss and the VAS score(P<0.05). No significant difference of the excellent and good rate of improved MacNab grading was found between two groups(P>0.05). Two years after the operation, no significant difference of the height loss of intervertebral was observed between two groups (P>0.05). But the average change of Cobb's angle of the experimental group was less than that of the control group (P<0.05). Conclusion: Compared with the internal fixation fusion surgery, Minimally invasive surgery had the advantage of less bleeding, less damage and quick recovery after operation in the treatment of the elder patients with LDH.S
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