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单节段腰椎间盘突出症的显微内镜下椎间盘切除术与开放椎间盘切除术的比较

Comparison of microendoscopic discectomy and open discectomy for single-segment lumbar disc herniation.

作者信息

Pang Jiu-Ya, Tan Fei, Chen Wei-Wei, Li Cui-Hua, Dou Shu-Ping, Guo Jing-Ran, Zhao Li-Ying

机构信息

Department of Traumatology, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China.

Intensive Care Unit, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China.

出版信息

World J Clin Cases. 2020 Jul 26;8(14):2942-2949. doi: 10.12998/wjcc.v8.i14.2942.

Abstract

BACKGROUND

Lumbar disc herniation is a common disease. Endoscopic treatment may have more advantages than traditional surgery.

AIM

To compare the clinical efficacy and safety of microendoscopic discectomy (MED) and open discectomy with lamina nucleus enucleation in the treatment of single-segment lumbar intervertebral disc herniation.

METHODS

Ninety-six patients who were operated at our hospital were selected for this study. Patients with single-segment lumbar disc herniation were admitted to the hospital from March 2018 to March 2019 and were randomly divided into the observation group and the control group with 48 cases in each group. The former group underwent lumbar discectomy and the latter underwent laparotomy and nucleus pulpectomy. Surgical effects were compared between the two groups.

RESULTS

In terms of surgical indicators, the observation group had a longer operation time, shorter postoperative bedtime and hospital stay, less intraoperative blood loss, and smaller incision length than the control group ( < 0.05). The excellent recovery rate did not differ significantly between the observation group (93.75%) and the control group (91.67%). Visual analogue scale pain scores were significantly lower in the observation group than in the control group at 1 d, 3 d, 1 mo, and 6 mo after surgery ( < 0.05). The incidence of complications was significantly lower in the observation group than in the control group (6.25% 22.92%, < 0.05).

CONCLUSION

Both MED and open discectomy can effectively improve single-segment lumbar disc herniation, but MED is associated with less trauma, less bleeding, and a lower incidence of complications.

摘要

背景

腰椎间盘突出症是一种常见疾病。内镜治疗可能比传统手术具有更多优势。

目的

比较微创内镜下椎间盘切除术(MED)与开放性椎板核摘除术治疗单节段腰椎间盘突出症的临床疗效及安全性。

方法

选取我院手术治疗的96例患者进行本研究。2018年3月至2019年3月收治的单节段腰椎间盘突出症患者被随机分为观察组和对照组,每组48例。前一组行腰椎间盘切除术,后一组行剖腹手术及髓核摘除术。比较两组的手术效果。

结果

在手术指标方面,观察组手术时间长于对照组,但术后卧床时间和住院时间短于对照组,术中出血量少,切口长度小(P<0.05)。观察组(93.75%)与对照组(91.67%)的优良恢复率差异无统计学意义。术后1天、3天、1个月和6个月时,观察组视觉模拟评分法疼痛评分显著低于对照组(P<0.05)。观察组并发症发生率显著低于对照组(6.25%对22.92%,P<0.05)。

结论

MED和开放性椎间盘切除术均可有效改善单节段腰椎间盘突出症,但MED创伤小、出血少、并发症发生率低。

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