腰椎间盘突出合并脊椎滑脱患者手术治疗的临床探索

摘要

Objective To explore the clinical effect of surgical treatment of patients with lumbar disc herniation associated with spondylo-listhesis. Methods One hundred and twenty seven patients with lumbar disc herniation associated with spondylolisthesis treated in Orthopedic Hospital during January 2010 to November 2013 were divided into observation group(71 cases)and control group(56 cases),patients in observa-tion group were given with discectomy under discoscopy,patients in control group were given with discectomy under the MAST Quadrant channel, and the prognosis of patients in both groups had been compared. Results The VAS scores of patients in observation group and control group were significantly lower than those before operation( P < 0. 05),and their ODI scores were significantly higher than those before surgery( P < 0. 05), and the difference was statistically significant;and the difference in duration of surgery,amount of blood loss,postoperative VAS scores and ODI scores between observation group and control group was not statistically significant( P ﹥ 0. 05). Conclusion Endoscopic discectomy and MAST Quadrant channel discectomy are effective means with less invasiveness in treatment of patients with lumbar disc herniation associated with spon-dylolisthesis,hence they can be widely used in clinical practice.%目的：探讨腰椎间盘突出合并脊椎滑脱患者手术治疗方式及临床效果。方法选取于2010年1月至2013年11月间收治的腰椎间盘突出合并脊椎滑脱患者127例，分为观察组（71例）和对照组（56例）。观察组给予椎间盘镜下髓核摘除术治疗，对照组给予 MAST Quadrant 通道下髓核摘除术治疗，比较两组患者的临床疗效及预后情况。结果观察组与对照组患者术后视觉模拟评分（ VAS）评分均明显低于术前（ P <0.05），Oswestry 功能障碍指数问卷表（ODI）评分均明显高于术前，差异具有统计学意义（ P <0.05）；观察组与对照组临床有效率、手术持续时间、出血量、术后 VAS 评分及 ODI 评分比较均无明显差异，差异无统计学意义（ P ﹥0.05）。结论椎间盘镜下髓核摘除术及 MAST Quadrant 通道下髓核摘除术均是治疗腰椎间盘突出合并脊椎滑脱的有效手段，且创伤较小，可以广泛应用于临床。