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500例腰椎间盘突出症显微椎间盘切除术与500例经皮激光椎间盘减压术的结果比较。

Comparison of results of 500 microdiscectomies and 500 percutaneous laser disc decompression procedures for lumbar disc herniation.

作者信息

Tassi Gian Paolo

机构信息

Department of Neurosurgery, Casa di Cura Villa Anna, San Benedetto del Tronto, and Casa di Cura Pierangeli, Pescara, Italy.

出版信息

Photomed Laser Surg. 2006 Dec;24(6):694-7. doi: 10.1089/pho.2006.24.694.

Abstract

OBJECTIVE

This article aimed to analyze the neurosurgical results of 500 patients treated with microdiscectomies and 500 patients treated with percutaneous laser disc decompression.

BACKGROUND DATA

It has been suggested in the literature that percutaneous laser disc decompression might be considered a serious and valid alternative to microdiscectomy in the treatment of patients with discogenic pain caused by herniated lumbar disc.

METHODS

Patients with herniated discs were treated by microdiscectomy (n = 500) according to the Caspar technique, and patients with discogenic pain were treated with percutaneous laser disc decompression (n = 500) according to the Choy technique. The inclusion and exclusion criteria were the same for both groups of patients. Age, gender distribution, multiple levels involved, and associated pathologies were not statistically different. The results were evaluated for both groups with the MacNab criteria. The follow-up period was 2 years (+/-1 year).

RESULTS

In the microdiscectomy group, 85.6% of patients (n = 428) had a good or excellent outcome; in the percutaneous laser disc decompression group, 83.8% of patients (n = 419) had a good or excellent outcome. Complications occurred in 2.2% (n = 11) in the microdiscectomy group and in 0% in the percutaneous laser disc decompression group.

CONCLUSION

The analysis of results for the two groups supports the conclusion that percutaneous laser disc decompression is a safe, minimally invasive, and strong alternative treatment to microdiscectomy in patients affected by herniated discs.

摘要

目的

本文旨在分析500例行显微椎间盘切除术患者和500例行经皮激光椎间盘减压术患者的神经外科手术结果。

背景资料

文献表明,在治疗因腰椎间盘突出症引起的椎间盘源性疼痛患者时,经皮激光椎间盘减压术可被视为显微椎间盘切除术的一种可靠且有效的替代方法。

方法

根据卡斯帕技术对椎间盘突出症患者行显微椎间盘切除术(n = 500),根据乔伊技术对椎间盘源性疼痛患者行经皮激光椎间盘减压术(n = 500)。两组患者的纳入和排除标准相同。年龄、性别分布、受累节段数量及相关病理情况在统计学上无差异。采用麦克纳布标准对两组结果进行评估。随访期为2年(±1年)。

结果

显微椎间盘切除术组中,85.6%的患者(n = 428)预后良好或极佳;经皮激光椎间盘减压术组中,83.8%的患者(n = 419)预后良好或极佳。显微椎间盘切除术组并发症发生率为2.2%(n = 11),经皮激光椎间盘减压术组为0%。

结论

两组结果分析支持以下结论:对于椎间盘突出症患者,经皮激光椎间盘减压术是一种安全、微创且有效的显微椎间盘切除术替代治疗方法。

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