Maroon J C, Abla A
Neurosurgery. 1985 May;16(5):644-9. doi: 10.1227/00006123-198505000-00010.
A retrospective analysis of 50 consecutive patients treated with chemonucleolysis and 50 treated with microlumbar discectomy was carried out. Similar clinical criteria for the diagnosis of "virgin" herniated lumbar discs were used. All patients had low back or radicular pain unrelieved by a minimum of 4 weeks of conservative therapy. Physical findings included a positive straight leg raising sign, weakness of the appropriate muscle groups, and a sensory loss or evidence of depressed reflexes. All had myelograms or computed tomographic scans demonstrating an extradural defect. Compensation cases were eliminated. Results demonstrated a 90% marked improvement in the microdiscectomy category and a 58% marked improvement in the chemonucleolysis group. Four per cent of the microdiscectomy patients were unimproved, and 18% of the chemonucleolysis group required a subsequent surgical procedure. The average postoperative hospital stay was 3 days for both groups. Because of the necessity for reoperations in the chemonucleolysis group, chemonucleolysis seemed less cost-effective than microdiscectomy.
对连续50例接受化学溶核术治疗的患者和50例接受显微腰椎间盘切除术治疗的患者进行了回顾性分析。采用了相似的“原发性”腰椎间盘突出症诊断临床标准。所有患者均有腰背痛或神经根性疼痛，经至少4周保守治疗后未缓解。体格检查发现包括直腿抬高试验阳性、相应肌群无力、感觉丧失或反射减弱。所有患者均有脊髓造影或计算机断层扫描显示硬膜外缺损。排除了赔偿病例。结果显示，显微椎间盘切除术组有90%显著改善，化学溶核术组有58%显著改善。显微椎间盘切除术组4%的患者未改善，化学溶核术组18%的患者需要后续手术。两组术后平均住院时间均为3天。由于化学溶核术组需要再次手术，化学溶核术似乎比显微椎间盘切除术成本效益更低。
