椎间盘镜和小切口开窗髓核摘除手术疗效比较

目的比较椎间盘镜(MED)与小切口开窗髓核摘除术治疗腰椎间盘突出症的临床疗效,探讨各自的手术适应证。方法200例腰椎间盘突出症患者分为两组,行MED和小切口开窗髓核摘除术各100例。结果按Naka i疗效评价标准,MED组优72例,良21例,可5例,差2例;小切口开窗手术组优70例,良20例,可6例,差4例。两组并发症主要为术后复发MED组2例,小切口开窗组3例;椎间盘炎各1例。无神经根及脊髓损伤。结论两种手术方式疗效均较为肯定,术后疗效大体一致,MED术中出血少,平均住院时间短,但对于多节段椎间盘突出、巨大型、游离型、中央型以及合并椎间盘钙化的手术,小切口开窗疗效较为显著。

Comparison of Therapeutic Effects between Microendoscopic Dissectomy and Removal of Nucleus Pulposus by Small-incision Fenestration

Objective To compare the therapeutic effects between microendoscopic dissectomy(MED) and removal of nucleus pulposus by small-incision fenestration,and to discuss their indications.Methods All the 200 patients with lumbar intervertebral disc herniation were averagely divided into two groups which accepted MED and removal of nucleus pulposus by small-incision fenestratio respectively.Results In the MED group,there were 72 patients whose therapeutic effects based on Nakai's Criterion were excellent,21 ones good,5 ones soso,and 2 ones not good.In the other group,the counterparts were 70,20,6 and 4 respectively.In respect of complication,there were two patients with recurrence in the MED group and three ones with recurrence in the other group.There was one patient with intervertebral disc inflammation in each group.There was no damage in nerve root or spinal cord.Conclusion Both the two operative means have definite and similar therapeutic effects.Furthermore,operative bleeding is little and mean hospitalization is short when MED is performed.With regard to nucleus pulposus removal by small-incision fenestration,it is apt for those with multiple intervertebral disc herniation which is large,free,central or calcified.