多节段腰椎间盘突出症的责任节段治疗与整体治疗的临床疗效比较.

Objective: To compare the clinical effect and safety of different depressing segments（responsible segment or total segments） in the treatment of herniation of Multi-segmented lumber intervertebral disc, HMLD. Methods: 78 cases of patients with herniation of Multi-segmented lumber intervertebral disc treated from 2010.01 to 2013.01 were retrospectively reviewed, in which 42 patients were treated by only responsible segment and 36 patients were treated by total segments. The clinical outcomes were evaluated and compared by lost, operation time, blood loss, postoperative hospital stay and intraoperative complications. The surgical results were evaluated according to the Visual Analogue Scale(VAS) and Japanese Orthopedic Association(JOA). Results: There was no significant difference between the two groups(experiment group and total segments) in the VAS score and JOA in 6, 12 and 36 months after the operation(P>0. 05). However, the VAS was significant better in experiment group on the day after the operation(P<0.05). The blood lost, money lost and the stay time in experiment group were significant better than that in control group (P<0.05); The complication incidence in experiment group was significant better than that in control group in the first year after the operation. One yaras later, the complication incidence in control group was less, however, there was no significant difference between the two groups (P>0.05). Conclusion: For the treatment of herniation of Multi-segmented lumber intervertebral disc, finding the responsible segment and treating could have the similar clinical efficacy compairing with the total segments depressing, which could have the less lost,operation trauma and the short-term complication. This treatment could be further recommended clinically. [ABSTRACT FROM AUTHOR]