经皮侧入路腰椎间盘切除术的临床应用  

Clinical application of percutaneous lateral lumbar discectomy

作　　者：姜文进[1] 孙博琳[1] 生琦瑞[1] 宋雪鹏[1] 郑延波[1] 王立刚[1] 

机构地区：[1]烟台毓璜顶医院介入放射科,山东烟台264000

出　　处：《生物医学工程与临床》2012年第2期140-143,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的评价经皮侧入路腰椎间盘切除术(PLLD)的手术疗效和安全性。方法2006年4月～2010年5月对163例腰椎间盘突出(L3～5)患者行PLLD。其中,男性92例,女性71例;年龄22～65岁,中位年龄46岁;病程6个月至21年。采用疼痛视觉模拟(VAS)评分及日本整形外科学会(JOA)腰椎功能评分评价手术疗效。结果163例患者均成功完成PLLD,手术成功率100%,无血管、肠管、神经损伤及术后感染等并发症。VAS评分由术前(6.75±2.32)降到术后(3.10±1.34)(P<0.05),JOA评分由术前(11.84±2.42)提高到术后(25.36±3.24)(P<0.05)。术后随访1～5年,优良率达94.5%。结论PLLD手术安全性高,创伤小,疗效好,适用于纤维环受损的L3～5腰椎间盘突出。Objective To evaluate the safety and efficacy of percutaneous lateral lumbar discectomy（PLLD）. Methods A total of 163 patients with lumbar disc herniation（L3_5） from April 2006 to May 2010 were enrolled, male 92 ,female 71, aged 22 - 65 years old, median age 46 years old, disease duration 6-month to 21 -year. All of cases were underwent PLLD, and clinical outcome wasevaluated by visual analogue scale（VAS） score and Japanese Orthopaedic Association （JOA） score. Results The successful rate of operation was 100 %. All cases had been successfully operated without any complication such as damage of blood vessel, intestinal canal and neural lesion,without postoperative infection. The VAS score was 6.75±2.32 of pre-operation and 3.10±1.34 of post-operation. The JOA score was 11.84±2.42 of pre-operation and 25.36 ＋ 3.24 of post-operation. There were significant difference in pre-operation and post-operation score （P 〈 0.05） of VAS and JOA. Followed-up 1 - 5 years, the excellent rate of operation was 94.5 %. Conelusion It is demonstrated that PLLD is a valuable approach to treatment of L3-5 severe intervertebral disc herniation with high safety, less injury and good outcome.

关 键 词：腰椎 经皮椎间盘切除术 侧入路 介入性放射学 摄影学 

分 类 号：R687.3[医药卫生—骨科学]