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经皮腰椎间盘切除术和显微内镜下椎间盘切除术治疗腰椎间盘突出症的长期疗效

[Long-term outcomes of percutaneous lumbar discectomy and microendoscopic discectomy for lumbar disc herniation].

作者信息

Liu Wen-gui, Wu Xiao-tao, Min Jie, Guo Jin-he, Zhuang Su-yang, Chen Xiao-hui, Deng Gang, He Shi-cheng, Fang Wen, Zhu Guang-yu, Teng Gao-jun

机构信息

Department of Radiology, Zhongda Hospital, Southeast University, Nanjing 210009, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2009 Mar 24;89(11):750-3.

Abstract

OBJECTIVE

To evaluate the long-term effects of percutaneous lumbar discectomy (PLD) and microendoscopic discectomy (MED) in treatment of lumbar disc herniation.

METHODS

A questionnaire survey by letter and telephone was conducted among 104 patients undergoing PLD and 82 patients undergoing MED during January 2000 to March 2002, to investigate the Oswestry disability index (ODI), Short Form-36 (SF-36) score, and Japanese Orthopedic Association (JOA) score.

RESULTS

The excellent/good rate (ODI score=0-20%) of the MED group was 79.27%, significantly higher than that of the PLD group (71.15%, P=0.0397). However, longer The hospitalization duration of the MED group was 11, 6 d, significantly longer than that of the PLD group (7.9 d, P<0.01), and the mean cost of the MED group was, significantly higher than that of the PLD group (P<0.01). Long-term complications were observed in 3 patients of the MED group (3.49%) while none in the PLD group.

CONCLUSION

Both PLD and MED are minimally-invasive-technique with a long-term efficacy and safety on lumbar disc herniation. Although the long-term outcome of the MED group is better than PLD, the complication rate, hospitalization duration, and cost of the MED group are higher.

摘要

目的

评估经皮腰椎间盘切除术(PLD)和显微内镜下椎间盘切除术(MED)治疗腰椎间盘突出症的长期效果。

方法

对2000年1月至2002年3月期间接受PLD的104例患者和接受MED的82例患者进行信函和电话问卷调查,以调查Oswestry功能障碍指数(ODI)、简明健康状况调查量表(SF-36)评分和日本矫形外科学会(JOA)评分。

结果

MED组的优良率(ODI评分=0-20%)为79.27%,显著高于PLD组(71.15%,P=0.0397)。然而,MED组的住院时间为11.6天,显著长于PLD组(7.9天,P<0.01),且MED组的平均费用显著高于PLD组(P<0.01)。MED组有3例患者出现长期并发症(3.49%),而PLD组无并发症发生。

结论

PLD和MED均为微创技术,对腰椎间盘突出症具有长期疗效和安全性。虽然MED组的长期效果优于PLD,但MED组的并发症发生率、住院时间和费用更高。

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