两种术式治疗腰椎间盘突出症的疗效比较OA

Objective To compare the therapeutic efficacy of unilateral laminotomy for bilateral decompression(UL-BD)and percutaneous endoscopic interlaminar discectomy(PEID)in the treatment of lumbar disc herniation(LDH).Methods The 58 patients with L4-5 segments LDH were divided into the ULBD group(treated with ULBD,30 ca-ses)and the PEID group(treated with PEID,28 cases)based on the surgical approach.The LDH recurrence rate,pain VAS,ODI,JOA score,and dural sac area were compared between the two groups.The MacNab criteria was used to evaluate efficacy.Results All patients were followed up for 6-8 months.The recurrence rate of LDH in the UL-BD group was lower than that in the PEID group(P＜0.05).At 1,3,6 months,the pain VAS had no difference be-tween two groups(P＞0.05);and the ODI,JOA scores in the ULBD group were both better than the PEID group(P＜0.05).The dural sac area was greater in the ULBD group than that in the PEID group at 3 d after the operation(P＜0.05).At 6 months after the operation,there was no significant difference in the excellent-good rate evaluated by MacNab criteria between the two groups(P＞0.05).Conclusions Both ULBD and PEID treatment of LDH can a-chieve satisfactory efficacy.Compared with PEID,ULBD has more thorough decompression and better dural sac area improvement,which can provide more space for nerve root activity,and is more conducive to the improvement of the patient's postoperative quality of life.