目的：探讨侧后方入路治疗高位腰椎间盘突出症( ULDH)的临床疗效。方法对20例ULDH患者行侧后方入路治疗。术前、术后2周及末次随访时进行腰痛视觉模拟评分法( VAS)及JOA评分。结果20例全部获得随访，时间12~24(18．8±2．3)个月。 VAS评分：术前为7．8分±1．3分，术后2周为1．3分±1．2分，末次随访时为1．4分±1．1分，术后2周及末次随访时与术前比较差异均有统计学意义( P<0．05)；JOA评分：术前为12．12分±2．12分，术后2周为20．60分±3．12分，末次随访时为21．88分±3．05分，术后2周及末次随访时与术前比较差异均有统计学意义(P<0．05)。疗效按Otani et al分级方法评定：优15例，良1例，可3例，差1例，优良率为16/20。结论侧后方入路治疗ULDH疗效明确。术中应仔细操作，以避免医源性损伤。%Objective To evaluate the clinical effect of posterior-lateral approach operation in the treatment of upper lumbar disc herniation ( ULDH) . Methods A total of 20 patients of ULDH underwent posterior-lateral approach, visual analogue scale ( VAS) score for lower back pain and Japanese Orthopaedic Association ( JOA) score were per-formed preoperatively, postoperative 2 weeks and at the final follow-up. Results All patients had an follow-up peri-od of 12~24(18. 8 ± 2. 3)months. The average VAS scores of preoperation, two weeks after the operation and the fi-nal follow-up were 7. 8 ± 1. 3,1. 3 ± 1. 2 and 1. 4 ± 1. 1 respectively,which was statistically significant different com-pared with the results of the preoperation (P<0. 05);The average JOA scores of preoperation, two weeks after the operation and the final follow-up were 12. 12 ± 2. 12,20. 60 ± 3. 12 and 21. 88 ± 3. 05 respectively, which was statisti-cally significant different compared with the results of the preoperation(P<0. 05). The clinical effect of the operation was evaluated by the Otani et al classification methods:clinical outcome was excellent in 15 patients, good in 1 and fair in 3, poor in 1, with excellent and good rate of 16/20. Conclusions Surgical treatment through posterior-lateral approach is a good method for ULDH,with significant therapeutic effect. Gentle and careful operation is the key to a-void the medical injury.
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