石新成

[摘要] 目的 分析对复发性腰椎间盘突出患者采用不同手术方式进行再手术治疗的临床疗效。 方法 随机选取64例该院2013年6月—2015年1月期间收治的复发性腰椎间盘突出患者，随机分为各32例患者的两组，对照组采用PLIF法；试验组采用改良PLIF法；对比两组相关指标。 结果 治疗后，两组患者较治疗前相关指标均改善；治疗后，试验组手术时间、术中出血量优于对照组，P<0.05，两组JOA评分、椎间高度变化差异无统计学意义，P>0.05。 结论 两组疗效并无太大差异，但试验组在手术时间以及手术过程中的出血量方面优于对照组。综合来看，改良PLIF法更适合在临床推广应用。

[关键词] 腰椎间盘突出；再手术；术式选择；疗效

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）02（b）-0069-02

[Abstract] Objective To analyze the clinical curative effect of adopting different operative methods for reoperation for patients with recurrent lumbar disc herniation. Methods 64 cases of patients with recurrent lumbar disc herniation treated in our hospital from June 2013 to January 2015 were randomly selected and randomly divided into two groups with 32 cases in each， the control group were treated with PLIF method， the test group were treated with modified PLIF method， the related indicators of the two groups were compared. Results The related indicators of the two groups after treatment were improved compared with those before treatment， after treatment ， the operation time and intraoperative blood loss in the test group were better than those in the control group P<0.05， the differences in the JOA score and intervertebral height change between the two groups were not obvious ，P>0.05. Conclusion The difference in the curative effect between the two groups was not obvious， the operation time and intraoperative blood loss in the test group were better than those in the control group. Overall， the modified PLIF method is more suitable for clinical promotion and application.

[Key words] Lumbar disc protrusion； Reoperation； Operative method selection； Curative effect

腰椎间盘突出症是发病率很高的一种骨科疾病，往往会对患者的正常生活造成很大困扰，而复发性腰椎间盘突出更是给患者的生活带来了极大的不便，其复发率在4%～18%之间[1]。常规再手术的方法为PLIF（双侧椎弓根螺钉内固定术），随着医疗水平的发展，近年来单侧椎弓根螺钉内固定术（改良PLIF）被更多的应用于临床[2-3]。该研究旨在通过对64例该院2013年6月—2015年1月期间收治的复发性腰椎间盘突出患者分别采用不同的手术方式进行治疗，来比较这两种方法对该病的临床治疗效果，现报道如下。

1 资料与方法

1.1 一般资料

在该院随机选取64例2013年6月—2015年1月期间就诊的复发性腰椎间盘突出患者，所有患者均需进行再手术治疗。将所有患者随机分为各32例患者的对照组和试验组，对照组平均年龄（32.4±10.7），平均病程（48.3±7.8）；……