Zhou Yue, Wang Jian, Chu Tong-wei, Li Chang-qing, Zhang Zheng-feng, Wang Wei-dong, Pan Yong
Department of Orthopaedics, Xinqiao Hospital, the Third Military Medical University, Chongqing 400037, China.
Zhonghua Wai Ke Za Zhi. 2008 Oct 1;46(19):1475-9.
To evaluate the results of micro-endoscopic revision surgery for recurrent disc herniation, and compare the results of disc excision with and without interbody fusion.
A total of 32 patients included who had undergone micro-endoscopic revision discectomy for recurrent disc herniation with or without interbody fusion has been surveyed to assess their clinical outcome. The 27 patients who had been followed were divided into two groups; the micro-endoscopic discectomy alone 14 cases, the micro-endoscopic discectomy with interbody fusion 13 cases. With an average follow-up of 25.5 months. Clinical symptoms were assessed based on the VAS scores and Nakai criteria. All medical and surgical records were examined and analyzed, including intraoperative blood loss, length of surgery, and postsurgery hospital stay et al.
The statistical difference in the postoperative back pain and leg pain score compared with preoperative score were significant (P < 0.05) or very significant (P < 0.01). Clinical outcomes were excellent or good in 92.8% of patients undergoing a micro-endoscopic discectomy alone, and in 85.5% of patients with interbody fusion. The statistical difference between the fusion and non-fusion groups was insignificant (P = 0.793). But the two groups intraoperative blood loss, length of surgery, length of hospitalization and expenses were significantly less in patients undergoing discectomy alone than in patients with interbody fusion.
Micro-endoscopic revision surgery for recurrent disc herniation is very effective and safety. Micro-endoscopic discectomy alone is first choice for managing recurrent disc herniation.
评估显微内镜翻修手术治疗复发性椎间盘突出症的效果，并比较单纯椎间盘切除术与椎间盘切除联合椎间融合术的疗效。
共纳入32例行显微内镜翻修椎间盘切除术治疗复发性椎间盘突出症（伴或不伴椎间融合）的患者，对其临床疗效进行评估。对随访的27例患者分为两组；单纯显微内镜椎间盘切除术14例，显微内镜椎间盘切除联合椎间融合术13例。平均随访25.5个月。根据视觉模拟评分法（VAS）评分和中井标准评估临床症状。检查并分析所有医疗和手术记录，包括术中失血量、手术时间和术后住院时间等。
术后背痛和腿痛评分与术前评分相比，差异有统计学意义（P < 0.05）或差异有非常显著统计学意义（P < 0.01）。单纯显微内镜椎间盘切除术患者中92.8%的临床疗效为优或良，椎间融合术患者中这一比例为85.5%。融合组与非融合组之间的差异无统计学意义（P = 0.793）。但单纯椎间盘切除术患者的术中失血量、手术时间、住院时间和费用均显著低于椎间融合术患者。
显微内镜翻修手术治疗复发性椎间盘突出症非常有效且安全。单纯显微内镜椎间盘切除术是治疗复发性椎间盘突出症的首选方法。
