目的:对比研究经后路显微镜下与传统的开窗手术治疗腰椎间盘突出症的临床疗效及差异.方法:2003年2月至2011年3月收治的467例腰椎间盘突出症患者,随机采用显微镜辅助下髓核摘除术治疗232例(A组),传统后路开窗手术治疗235例(B组).统计两组手术时间、切口长度、术中出血量等指标.结果:手术时间、术中出血量、手术切口长度等指标两组比较差异均有统计学意义.术后两组切口均Ⅰ期愈合.无手术间隙定位错误、神经根损伤等并发症发生.采用中华医学会腰背痛手术评定标准评定疗效,两组优良率比较差异无统计学意义(P＞0.05).结论:两种方法临床效果接近,而显微镜下手术具有创伤小,出血少、手术时间短,住院时间短,医疗费用少等优点,是治疗腰椎间盘突出症的一种理想微创手术.%Objective To study the clinical outcomes of micro discectomy versus open fenestration discectomy in the treatment of lumbar disc herniation. Methods A prospectively study was carried out for 467 patients suffering from lumbar disc herniation from February 2003 to March 2011, cases were randomized to allocate into two groups, the micro discectomy group A (n = 232) and the open fenestration discectomy group B (n = 235). Operation time, approach incision length, intraoperative blood loss ect were analyzed. Results The difference of indicators such as operative time, bleeding volume and the length of incision between the two groups were statistically significant. One-stage incision healing were achieved in all patients. There were not complications such as positioning errors, nerve root injury and others. The clinical effect were assessed according to the standards of Scoring System of Chinese Spinal Association (CSA), there were no significant differences between two groups (P > 0.05). Conclusion Both the two operation methods can obtain the same satisfied results of therapy, but micro discectomy has advantages of minimal invasion, less blood loss, shorter operation time, shorter hospital stay, fewer medical expenses etc, and can be one of ideal minimal invasion operation.
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