Henriksen L, Schmidt K, Eskesen V, Jantzen E
Department of Neurosurgery, Glostrup Hospital, University of Copenhagen, Denmark.
Br J Neurosurg. 1996 Jun;10(3):289-93. doi: 10.1080/02688699650040160.
The purpose of the study was to evaluate whether a microsurgical discectomy (MS), compared with a standard lumbar discectomy (SD), could reduce the stay at the hospital or the postoperative morbidity. The study was prospective and of 79 patients with "virgin' lumbar radiculopathy from only one nerve root, 39 were randomized to MS and 40 to SD. All patients had positive myelography or CT findings. The fascia incision was 31 and 70 mm (p < 0.0001), respectively, but the skin incision was of the same length in both groups to blind the study. For the MS and SD group of patients, the median operation time was 48 and 35 min (p < 0.0001), and the stay at the hospital was 5.2 and 4.6 days, respectively. The two groups were not different in sex, age, localization or type of herniated discs. Use of analgesic medicine and the presence of pain in the back or legs pre- and postoperative was the same. We conclude that in a controlled and prospective study, reducing the fascia incision and the muscular dissection from a median of 70-31 mm, does not shorten the length of a stay at a hospital and it has no influence on postoperative morbidity.
本研究的目的是评估与标准腰椎间盘切除术（SD）相比，显微外科椎间盘切除术（MS）是否能缩短住院时间或降低术后发病率。该研究为前瞻性研究，79例仅一根神经根出现“原发性”腰椎神经根病的患者被随机分为两组，39例接受MS，40例接受SD。所有患者脊髓造影或CT检查结果均为阳性。筋膜切口分别为31mm和70mm（p<0.0001），但两组皮肤切口长度相同，以确保研究的盲法。MS组和SD组患者的中位手术时间分别为48分钟和35分钟（p<0.0001），住院时间分别为5.2天和4.6天。两组在性别、年龄、椎间盘突出的部位或类型方面无差异。术前和术后使用镇痛药的情况以及背部或腿部疼痛的情况相同。我们得出结论，在一项对照前瞻性研究中，将筋膜切口和肌肉分离从平均70mm减少到31mm，并不会缩短住院时间，也不会对术后发病率产生影响。
