经脊柱后路椎间盘镜手术治疗L4/L5椎间孔狭窄临床效果观察(1)
【摘要】 目的 分析經脊柱后路椎间盘镜手术治疗L4/L5椎间孔狭窄临床效果。方法 84例L4/L5椎间孔狭窄患者随机分为治疗组和参照组， 各42例。参照组患者行肌间隙入路椎间融合术治疗；治疗组患者行经脊柱后路椎间盘镜手术干预。对两组患者的疼痛状况[采用视觉模拟评分(VAS)评价]及功能恢复情况(采用Nakai分级评价)进行对比。结果 治疗组患者术前VAS评分为(6.83±1.09)分、术后1周为(1.14±0.41)分、术后3个月为(0.97±0.31)分、术后6个月为(0.59±0.22)分；参照组患者术前VAS评分为(6.91±1.21)分、术后1周为(2.24±0.47)分、术后3个月为(1.76±0.36)分、术后
6个月为(0.68±0.28)分。两组术前VAS评分对比， 差异无统计学意义(P>0.05)；治疗组患者术后1周和3个月的VAS评分明显低于参照组(P<0.05)；两组术后6个月VAS评分对比， 差异无统计学意义(P>0.05)。术后6个月， 治疗组术后Nakai分级优良率为90.48%；参照组术后Nakai分级优良率为71.43%， 治疗组患者Nakai分级优良率明显高于参照组(P<0.05)。结论 经脊柱后路椎间盘镜手术治疗L4/L5椎间孔狭窄能够显著改善患者功能、降低疼痛症状， 具有较好的临床作用， 值得推广。
【关键词】 经脊柱后路；椎间盘镜手术；L4/L5椎间孔狭窄；临床效果
DOI：10.14163/j.cnki.11-5547/r.2017.01.026
Observation of clinical effect by spinal posterior approach Micro Endo Disc operation in the treatment of L4/L5 lumbar foraminal stenosis LI Gang. Liaoning Fushun City Mining Bureau General Hospital， Fushun 113008， China
【Abstract】 Objective To analyze clinical effect by spinal posterior approach Micro Endo Disc operation in the treatment of L4/L5 lumbar foraminal stenosis. Methods A total of 84 patients with L4/L5 lumbar foraminal stenosis were randomly divided into treatment group and control group， with 42 cases in each group. The control group received spatium intermusculare approach intervertebral fusion surgery for treatment， and the treatment group received spinal posterior approach Micro Endo Disc operation intervention. Comparison was made on pain condition [evaluated by visual analogue scale (VAS)] and functional rehabilitation situation (evaluated by Nakai grading evaluation) between the two groups. Results The treatment group had VAS score as (6.83±1.09) points before operation， (1.14±0.41) points in postoperative 1 week， (0.97±0.31) points in postoperative 3 months and (0.59±0.22) points in postoperative 6 months. The control group had VAS score as (6.91±1.21) points before operation， (2.24±0.47) points in postoperative 1 week， (1.76±0.36) points in postoperative 3 months and (0.68±0.28) points in postoperative 6 months. There was no statistically significant difference of VAS score before operation between the two groups (P>0.05). The treatment group had much lower VAS scores in postoperative 1 week and 3 months than those in the control group (P<0.05)， while their difference of VAS score in postoperative 6 months had no statistical significance (P>0.05). In postoperative 6 months， the treatment group had good rate of postoperative Nakai grading as 90.48%， which was 71.43% in the control group. The treatment group had obviously higher good rate of Nakai grading than the control group (P<0.05). Conclusion Spinal posterior approach Micro Endo Disc operation can remarkably improve function and relieve pain symptom in the treatment of L4/L5 lumbar foraminal stenosis patients. This method contains excellent clinical effect， and it is worth promoting., 百拇医药(李钢)
6个月为(0.68±0.28)分。两组术前VAS评分对比， 差异无统计学意义(P>0.05)；治疗组患者术后1周和3个月的VAS评分明显低于参照组(P<0.05)；两组术后6个月VAS评分对比， 差异无统计学意义(P>0.05)。术后6个月， 治疗组术后Nakai分级优良率为90.48%；参照组术后Nakai分级优良率为71.43%， 治疗组患者Nakai分级优良率明显高于参照组(P<0.05)。结论 经脊柱后路椎间盘镜手术治疗L4/L5椎间孔狭窄能够显著改善患者功能、降低疼痛症状， 具有较好的临床作用， 值得推广。
【关键词】 经脊柱后路；椎间盘镜手术；L4/L5椎间孔狭窄；临床效果
DOI：10.14163/j.cnki.11-5547/r.2017.01.026
Observation of clinical effect by spinal posterior approach Micro Endo Disc operation in the treatment of L4/L5 lumbar foraminal stenosis LI Gang. Liaoning Fushun City Mining Bureau General Hospital， Fushun 113008， China
【Abstract】 Objective To analyze clinical effect by spinal posterior approach Micro Endo Disc operation in the treatment of L4/L5 lumbar foraminal stenosis. Methods A total of 84 patients with L4/L5 lumbar foraminal stenosis were randomly divided into treatment group and control group， with 42 cases in each group. The control group received spatium intermusculare approach intervertebral fusion surgery for treatment， and the treatment group received spinal posterior approach Micro Endo Disc operation intervention. Comparison was made on pain condition [evaluated by visual analogue scale (VAS)] and functional rehabilitation situation (evaluated by Nakai grading evaluation) between the two groups. Results The treatment group had VAS score as (6.83±1.09) points before operation， (1.14±0.41) points in postoperative 1 week， (0.97±0.31) points in postoperative 3 months and (0.59±0.22) points in postoperative 6 months. The control group had VAS score as (6.91±1.21) points before operation， (2.24±0.47) points in postoperative 1 week， (1.76±0.36) points in postoperative 3 months and (0.68±0.28) points in postoperative 6 months. There was no statistically significant difference of VAS score before operation between the two groups (P>0.05). The treatment group had much lower VAS scores in postoperative 1 week and 3 months than those in the control group (P<0.05)， while their difference of VAS score in postoperative 6 months had no statistical significance (P>0.05). In postoperative 6 months， the treatment group had good rate of postoperative Nakai grading as 90.48%， which was 71.43% in the control group. The treatment group had obviously higher good rate of Nakai grading than the control group (P<0.05). Conclusion Spinal posterior approach Micro Endo Disc operation can remarkably improve function and relieve pain symptom in the treatment of L4/L5 lumbar foraminal stenosis patients. This method contains excellent clinical effect， and it is worth promoting., 百拇医药(李钢)