胸椎间盘突出症后外侧入路与后正中入路手术的并发症分析Complications occurring in the treatment of thoracic disc herniation using posterolateral and posterior entrances
李宝俊;孙亚澎;丁文元;申勇;赵金彩;张为;杨大龙;
摘要(Abstract):
[目的]总结经后外侧入路手术治疗胸椎间盘突出症的疗效及并发症并与后正中入路进行比较。[方法]回顾分析本院1998年11月~2007年2月间收治的77例胸椎间盘突出症患者的临床资料,其中采用经一侧关节突切除后外侧入路手术治疗51例(A组),采用后正中入路椎板切除减压术治疗26例(B组)。采用Otanni评分系统进行疗效评估,并计算临床优良率;观察两组治疗效果及并发症情况,计算神经功能改善率;应用SPSS13.0软件对数据进行统计学处理。[结果]手术时间A组130~185min,平均162min,B组145~205min,平均168min,两组间无显著性差异(P=0.062)。出血量A组400~600ml,平均485ml,B组500~800ml,平均646ml,两组间有显著性差异(P=0.013)。A组临床疗效评定优26例,良18例,可6例,差1例,临床优良率为86.3%;B组优10例,良8例,可6例,差2例,临床优良率69.2%,两组间有显著性差异(P=0.025)。A组中术后神经功能改善不明显2例,脊髓反应性水肿1例,内固定松动取出2例,脊髓前动脉综合征1例,脑脊液漏1例,神经功能改善率为90.2%。B组中术后神经功能改善不明显6例,脊髓反应性水肿1例,脑脊液漏2例,脊髓前动脉综合征1例,内固定松动取出1例,神经功能改善率为61.5%,两组相比有统计学差异(P=0.034)。[结论]经一侧关节突切除后外侧入路较后正中入路手术治疗胸椎间盘突出症的临床效果良好、神经功能恢复率高、手术安全性高。
关键词(KeyWords): 手术治疗;胸椎;椎间盘;并发症;后外侧入路
基金项目(Foundation): 河北省科技攻关项目资助(编号:0327619D-23)
作者(Author): 李宝俊;孙亚澎;丁文元;申勇;赵金彩;张为;杨大龙;
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