关键词: 腰椎间盘突出症, 微创, 显微镜

Abstract: Objective To evaluate the efficiency of surgical treatment of lumbar disc herniation by microsurgical lumbar discectomy (MSLD). Methods A clinical review was conducted on the two surgical methods for single segment lumbar disc herniation (LDH) from April 2007 to June 2010, one group of 30 patients who underwent microsurgical lumbar discectomy (MSLD) and the other of 30 patients who underwent open lumbar discectomy (OLD). The factors considered included the length of skin incision, the operative time, volume of intraoperative bleeding, duration of hospitalization, pre- and postoperative assessment based on the criteria of Japanese Orthopaedic Association (JOA) Scores, visual analog scale (VAS), and the Oswestry disability index (ODI). Results The mean length of skin incision was (2.8±0.8)cm and (5.5±1.8)cm, the operative time was (57.0±16.9) min and (72.0±30.5) min, the blood loss was (85.0±33.0) mL and (110.0±48.0) mL, the hospitalization time was (10.2±2.5) days and (12.2±3.6) days for MSLD and OLD respectively. All had significant difference (P<0.01). Three months after the operation, the improvement rate of JOA was 85.3%±8.3％ and 84.9%±7.6％ for MSLD and OLD respectively. The improvement rate of VAS score was 86.4%±1.9％.and 84.4%±2.1％ for MSLD and OLD respectively. The improvement rate of ODI score was 81.5%±6.3％ and 80.8%±5.6％ for MSLD and OLD respectively. None showed any significant difference (P>0.05). Conclusion MSLD has advantages of little cut, little bleeding, clear surgery field, safety, little hurt to nerve root and dura mater. But skilled operation requires a relatively long period of microsurgery training as foundation.

Key words: lumbar disc herniation, minimally invasive, microscopy