Spotlight通道系统与显微内窥镜椎间盘切除术治疗腰椎椎间盘突出症临床对比  

Comparison of clinical efficacy between Spotlight work channel system and microendoscopic discectomy in treatment of lumbar disc herniation

作　　者：徐海栋[1] 赵建宁[1] 付强[2] 

机构地区：[1]南京军区南京总医院骨科,江苏210002 [2]第二军医大学附属长海医院骨科

出　　处：《脊柱外科杂志》2013年第4期193-197,共5页Journal of Spinal Surgery

基　　金：南京军区南京总医院院管课题(2013017)

摘　　要：目的比较Spotlight通道系统和显微内窥镜椎间盘切除术(microendoscopic discectomy,MED)技术治疗腰椎间盘突出症的临床应用特点及疗效。方法 2011年3月～2012年3月收治的椎间盘突出症选择微创治疗患者40例,其中男26例,女14例;年龄26～58岁,平均41.7岁。患者随机分入Spotlight通道系统和MED技术治疗组,2组患者基本资料经统计学分析差异无统计学意义。对2组患者手术时间、术中出血量、手术切除的骨与韧带组织量、平均住院时间、并发症发生情况以及手术前、术后6个月随访时腰腿痛视觉模拟量表(visual analog scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)进行对比分析。结果 2组患者均获得随访。Spotlight组和MED组的手术时间分别为(53.2±11.4)min和(78.1±12.5)min,差异有统计学意义(P<0.05);2组术中出血量、切除的骨与韧带量、平均住院时间、并发症发生情况的差异无统计学意义(P>0.05)。同组术后6个月VAS评分、ODI与术前相比明显改善(P<0.05);手术前后2组之间的差异无统计学意义(P>0.05)。结论 Spotlight通道系统是"直视下的微创"手术方式之一,具有与MED近似的临床疗效,且其由于操作灵活具有更为广泛的适应证,更易为脊柱外科医师所掌握。Objective To compared the clinical application characteristic and the curative effect between Spotlight work channel system and microendoscopic discectomy （MED）. Methods From March 2011 to March 2012, 40 patients with disc herniation （26 males and 14 females, with a mean age of 41.7 years） were included in this study. They were divided into 2 groups randomly and equally： Spotlight work channel system group and MED group. Perioperative parameters （ operation time, bleeding volume, intraoperative excision of bone and ligament organization quality, length of hospital stay and complications）, preoperative and 6 months postoperative visual analog scale （VAS） scores of leg and back pain and Oswestry disability index （ODI） were statistically analyzed. Results All patients in 2 groups were followed up. The operation time of Spotlight work channel system group was （52.3 ± 11.4） min and the time of MED group was （78.1 ± 12.5） min; and the difference was statistically significant （ P 〈 0.05 ）. There were no significant differences in length of hospital stay, bleeding volume, intrao- perative excision of ligament and bone organization quality and complications between 2 groups （P 〉 0. 05）. With regard tO VAS scores and ODI, statistically significant differences were found in each group between pre-operation and postoperative 6 months （P 〈 0. 05 ）. However, there was no significant difference between the 2 groups（P 〉 0.05）. Conclusion Spotlight work channel system is an ＂ orthophoria minimally invasive surgery＂, which has the similar clinical curative effects with MED. It has more extensive indications because of operating space flexibility and is easier for spine surgeon to master the technology.

关 键 词：腰椎 椎间盘移位 外科手术 微创性 椎间盘切除术 

分 类 号：R681[医药卫生—骨科学]