發(fā)布時(shí)間：2019-01-27 05:55

【摘要】：目的觀察Quadrant通道下治療老年性腰椎間盤(pán)突出癥的臨床療效。方法 Quadrant通道下治療老年性腰椎間盤(pán)突出癥54例。其中男30例,女24例;年齡62~76歲,平均(67.3±4.52)歲。手術(shù)節(jié)段:L3/46例,L4/5 14例,L5/S1 34例�；颊呔蠿線片、MRI檢查確診單純的椎間盤(pán)突出,無(wú)節(jié)段不穩(wěn)。末次隨訪時(shí)采用疼痛視覺(jué)模擬評(píng)分(VAS),改良下腰痛ODI評(píng)分、改良Mac Nab標(biāo)準(zhǔn)評(píng)定患者癥狀改善情況。結(jié)果手術(shù)時(shí)間30~90 min,平均(50.00±7.53)min;術(shù)中出血量30~100 m L,平均(60.0±12.5)m L。手術(shù)切口有3例延遲愈合;術(shù)中2例發(fā)生腦脊液漏,未行修補(bǔ),術(shù)后2 d拔除引流管,行皮膚縫合后切口愈合。術(shù)后無(wú)椎間隙感染、神經(jīng)損傷等并發(fā)癥發(fā)生。全部病例獲完整隨訪,隨訪時(shí)間12~36個(gè)月,平均(20.00±3.53)個(gè)月。末次隨訪時(shí),VAS評(píng)分由術(shù)前的(7.25±0.68)分降至(1.83±0.59)分,差異有統(tǒng)計(jì)學(xué)意義(t=13.14,P=0.00)。ODI%評(píng)分由術(shù)前的(74.08±5.31)分降至(28.20±3.10)分,差異有統(tǒng)計(jì)學(xué)意義(t=7.68,P=0.00)。按改良Mac Nab標(biāo)準(zhǔn)評(píng)價(jià)療效,優(yōu)40例,良8例,中6例,優(yōu)良率88.9%。結(jié)論 Quadrant通道下椎間盤(pán)突出髓核摘除術(shù)具有創(chuàng)傷小、并發(fā)癥少等優(yōu)點(diǎn),是治療老年性腰椎間盤(pán)突出癥的一種安全有效的微創(chuàng)手術(shù)方法。
[Abstract]:Objective to observe the clinical effect of Quadrant channel in the treatment of senile lumbar disc herniation. Methods 54 cases of senile lumbar disc herniation were treated with Quadrant channel. There were 30 males and 24 females, with an average age of (67.3 鹵4.52) years. Surgical segment: l 3 / R 46 cases, L 4 / 5 14 cases, L5/S1 34 cases. All patients underwent X-ray and MRI examination confirmed simple disc herniation without segmental instability. At the last follow-up, pain visual analogue score (VAS),) was used to improve the ODI score of low back pain, and the modified Mac Nab standard was used to evaluate the improvement of symptoms. Results the mean time of operation was (50.00 鹵7.53) min;, the mean time of operation was (30 鹵7.53) min;, the mean blood loss was (60.0 鹵12.5) m L.). Cerebrospinal fluid leakage occurred in 2 cases, no repair was performed, drainage tube was pulled out 2 days after operation, incision healed after skin suture. There were no postoperative complications such as intervertebral space infection and nerve injury. All patients were followed up for 12 ~ 36 months (mean (20.00 鹵3.53) months). At the last follow-up, the VAS score decreased from (7.25 鹵0.68) to (1.83 鹵0.59), and the ODI% score decreased from (74.08 鹵5.31) to (28.20 鹵3.10). The difference was statistically significant (t = 7.68, P < 0.001). According to the improved Mac Nab criterion, the curative effect was evaluated in 40 cases, good in 8 cases and fair in 6 cases. The excellent and good rate was 88.9%. Conclusion Quadrant channel excision of nucleus pulposus herniated intervertebral disc has the advantages of less trauma and less complications. It is a safe and effective minimally invasive method for the treatment of senile lumbar disc herniation.
【作者單位】： 清遠(yuǎn)市人民醫(yī)院骨科一區(qū);
【基金】：廣東省醫(yī)學(xué)科學(xué)技術(shù)研究基金項(xiàng)目(編號(hào):A2015222)
【分類(lèi)號(hào)】：R687.3

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