【摘要】 目的 :探讨老年性腰椎间盘突出症 (LDH)的临床分型及其作为脊柱内窥镜 (MED)手术适应症的临床价值。方法 :参照老年性LDH的病理特点 ,将 81例年龄超过 5 0岁并已通过传统开放手术证实了椎管内合并症情况的LDH患者 (A组 )的临床特征分为Ⅰ ,Ⅱ两型并与其术中所见做对照分析 ;对行MED手术治疗的 6 2例年龄超过 5 0岁的患者 (B组 )进行回顾分析 ,并对其疗效做分型比较。结果 :A组Ⅰ型患者椎管狭窄总合并率为 6 2 .0 7% ,Ⅱ型患者椎管狭窄总合并率为 10 7.6 9% (P <0 .0 1) ;B组患者均获随访 ,平均随访 10月 ,按Macnnab标准评定疗效 ,Ⅰ型患者的手术优良率 (10 0 % )明显高于Ⅱ型 (75 % ,P <0 .0 5 )。结论 :老年性LDH的临床分型对提高MED手术疗效有着重要影响 ,可作为MED手术的适应症之一在临床推广应用更多还原

【Abstract】 Objective To study the value of the classification of the elderly lumbar disc herniation(LDH) as an indication of microendoscopic discectomy(MED). Methods Based on the pathological features of the elderly LDH, eighty-one patients over fifty years old (Group A) were proved to be intraspinal complications by traditional operation and were divided into I and II types which were compared with what were seen in the operation. Sixty-two patients over 50 years old (Group B) were treated with MED and reviewed retrospectively, and their curative effects were compared with their types. Results A general intraspinal narrowness rate of Group A was 62.07% in Type I , 107.69% in Type II (P<0.01). Group B was all followed up (mean 10 months). According to the macnnab criterion, the satisfactory rate was 100% in Type I, 75% in Type II (P<0.05). Conclusion The clinical classification of the elderly LDH makes a significant effect on the treatment of MED, can be used as an indication of MED, and can be popularized in clinic.更多还原