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郭瑛,云雄,邹重文,陆焱,邢国,张晓伟,梁昌海.有限髓核摘除结合纤维环缝合治疗腰椎椎间盘突出症的早期疗效[J].脊柱外科杂志,2017,15(6):326-330.
有限髓核摘除结合纤维环缝合治疗腰椎椎间盘突出症的早期疗效     点此下载全文 (Fulltext)
郭瑛  云雄  邹重文  陆焱  邢国  张晓伟  梁昌海
中国人民解放军第一八七中心医院脊柱外科, 海南 571159
基金项目:吴阶平医学基金会临床科研专项资助基金(320274516263)
DOI:10.3969/j.issn.1672-2957.2017.06.002
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摘要:
      目的 观察有限髓核摘除结合纤维环缝合治疗腰椎椎间盘突出症的早期临床疗效。方法 对2015年1月-2016年3月在本院行有限髓核摘除术的59例腰椎椎间盘突出症患者临床资料进行回顾性对照研究。缝合组28例行小切口腰椎椎板开窗有限髓核摘除结合纤维环缝合术;对照组31例行小切口腰椎椎板开窗有限髓核摘除,未行纤维环缝合。采用MacNab标准对术后1、3、6个月的治疗效果进行评价,同时采用椎间盘高度及椎间盘夹角对术后6个月时的脊柱稳定性进行评价。结果 术后1、3个月2组MacNab评分优良率比较差异无统计学意义;术后6个月时缝合组患者优良率高于对照组,差异有统计学意义(P < 0.05)。术后6个月时缝合组患者椎间盘高度高于对照组,差异有统计学意义(P < 0.05),椎间盘夹角小于对照组,差异有统计学意义(P < 0.05)。随访6个月无复发及再手术患者。结论 有限髓核摘除结合纤维环缝合术治疗腰椎椎间盘突出症安全、可靠,能获得满意的早期临床疗效且不影响脊柱稳定性,是降低复发率和再手术风险的一种行之有效的方法,值得临床推广应用。
关键词:腰椎  椎间盘移位  椎间盘切除术
Early treatment response of finite lumbar discectomy combined with annulus fibrosus suture for lumbar intervertebral disc herniation    Fulltext
GUO Ying  YUN Xiong  ZOU Zhong-wen  LU Yan  XING Guo  ZHANG Xiao-wei  LIANG Chang-hai
Department of Spinal Surgery, No. 187 Central Hospital of Chinese PLA, Haikou 571159, Hainan, China
Fund Project:
Abstract:
      Objective To observe the early clinical efficacy of finite discectomy combined with annulus fibrosus repair in the treatment of lumbar disc herniation. Methods From January 2015 to March 2016,59 patients who underwent finite discectomy caused by lumbar disc herniation were retrospectively analyzed. The 28 out of the 59 patients received annulus fibrosus suture as the treatment group,while another 31 patients without suture as the control group. Then evaluation indexes included surgery time,bleeding volume,complication,length of stay. MacNab criteria was used to evaluate improvement of the functional status at postoperative 1,3,6 months. Intervertebral disc height and angle were used to evaluate and compare the postoperative spinal stability between the 2 groups at postoperative 6 months. Results There was no significant difference in MacNab criteria between the 2 groups at postoperative 1 and 3 months. At postoperative 6 moths,MacNab criteria of treatment group was significantly superior to that of control group,and the difference was statistically significant(P < 0.05). Meanwhile,intervertebral disc height of treatment group was higher than that of control group,and the difference was statistically significant(P < 0.05). The intervertebral disc angle is smaller than that of control group,and the difference was statistically significant(P < 0.05). No recurrence and no re-operation happened in the near future. Conclusion Finite lumbar discectomy combined with annulus fibrosus suture in the treatment of lumbar disc herniation is safe and reliable,and can lead to satisfactory early clinical efficacy and do not affect the stability of the spine. In addition,it is an effective method for reducing the risk of recurrence and re-operation,and being worthy of clinical wider application.
Keywords:Lumbar vertebrae  Intervertebral disc displacement  Diskectomy
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