【摘要】 目的 :判定椎板后路手术治疗腰间盘突出症的远期疗效 ,为临床手术治疗腰间盘突出症提供一定的理论基础。方法 :应用Roland、Greenough标准及来院查体随访 1984～ 1991年间因患腰间盘突出症于我院行首次后路腰间盘摘除术的患者 ,有效随访 118例 ,随访时间 3～ 11年。结果 :应用两标准判定手术成功率分别为 86 .44%及 91.5 3% ,术后查体中有直腿抬高试验、加强试验、肌力脊柱叩压痛有显著恢复 ,而神经反射、脊柱活动度及痛觉障碍则无明显改善。按年龄及病程进行分层分析 ,显示各层间无显著性差异。结论 :后路腰间盘摘除术治疗腰间盘突出症有较高的手术成功率 ,但术后只有部分术前体症有显著恢复。手术方式的选择应强调个体化 ,综合考虑腰椎稳定性与彻底减压的关系。对年轻单纯腰椎间盘突出的患者应尽量保留腰椎后部结构 ,而对老年合并椎管狭窄的患者则应适当扩大切除范围更多还原

【Abstract】 Objective: To determine the long term outcome of posterior discectomy quantitatively. Methods: The Roland, Greenough questionnaires and postoperative examination were used to follow up the patients who underwent first posterior discectomy in our hospital during 1984 and the end of 1991. 118 patients were followed up for 3～11 years. Results: The postoperative good results were 86.44% and 91.53% respectively. The straight leg raising test, Bragdad test, muscle strength and percussion pain of the vertebrae had significant recover, but the knee and Achilles reflexes, movement of lumbar vertebrae and paralgesia did not recover significantly. The stratum analysis by age and duration of disease revealed no significant difference among the stratums. Conclusions: High percentage of good results after posterior lumbar discectomy, but only part of the examination items recovered. We should emphasize individualization in selection of means of operation. The posterior structure of vertebrae should be reserved in young and simple disc protrusion. As for the older patients who usually suffered from lumbar stenosis. At the same time, the excise scope should be enlarged.更多还原