TESSYS椎间孔镜技术在腰椎间盘突出症中治疗技巧探讨  

TECHNIQUES OF PERCUTANEOUS TRANSFORAMINAL ENDOSCOPIC SPINE SySTEM FOR PATIENTS WITH LUMBAR DISC HERNIATIONS

作　　者：薛祥云[1] 左小华[1] 赵红霞[1] 张前西 王茜[1] 陈波涛[1] 马柯[1] 刘延青[2] 

机构地区：[1]江苏省淮安市第二人民医院疼痛科,淮安223002 [2]首都医科大学附属北京天坛医院疼痛科,北京100050

出　　处：《中国疼痛医学杂志》2014年第6期401-404,共4页Chinese Journal of Pain Medicine

摘　　要：目的:探讨TESSYS椎间孔镜技术(transforaminal endoscopic spine system)治疗腰椎间盘突出症的疗效,总结临床经验。方法:对2011年5月至2012年3月期间的腰椎间盘突出症患者21例,手术效果采用视觉模拟评分法(visual analogue score,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)和改良MacNab疗效评定标准测评入院时和TESSYS椎间孔镜术后(术后1周、术后1月、术后3个月和术后6个月)。结果:术后1周、术后1月、术后3个月和术后6个月VAS分别为(2.90±0.88)、(1.57±0.50)、(1.57±0.74)和(2.14±0.65)均显著低于术前的(8.71±0.84)(P均<0.01);ODI分别为(26.60±8.12)%、(21.80±10.05)%、(24.70±12.13)%和(20.02±10.41)%均显著低于术前的(76.80±12.08)%(P均<0.01)。根据改良MacNab疗效评定优17例,良2例,可2例。术后优良率为90.47%,3例老年患者于术后出现腰背肌肉痉挛,予神经阻滞、药物和理疗处理后症状消失。结论:TESSYS椎间孔镜对腰椎间盘突出症近期疗效确切,术后应用适当的综合治疗有利于病人的康复。Objective：To assess therapeutic effect and treatment techniques of percutaneous transforarninal endoscopic discectomy （PTED） for releasing pain from lumbar disc hemiations.Methods：Twenty one patients were treated with percutaneous Wansforaminal endoscopic discectomy,and their improvement after operation was evaluated according to the visual analogue scale （VAS）,Oswestry disability index （ODI） and the modified MacNab criterion.Results：The mean pain scores of VAS （ODI） before and at one week,one,three and six months after treatment and at the final follow-up were 8.71 ± 0.84,2.90 ± 0.88,1.57 ± 0.50,1.57± 0.74,2.14 ± 0.65 （76.80±12.08%,26.60± 8.12%,21.80±10.05%,24.70±12.13% and 20.02±10.41%）,respectively.According to modified criteria for grading results,90.47% of these patients had excellent and good outcomes at one week,one and three months after treatment.Three cases of elderly patients come to back muscle spasms after operation,the symptoms disappeared after the treatment of nerve block,medicine and physical therapy.Conclusion：Percutaneous transforaminal endoscopic discectomy are effective in the treatment of pain resulting from lumbar disc hemiations.Postoperative treatment may facilitate the patient＇s recovery.

关 键 词：TESSYS椎间孔镜 腰椎间盘突出症 治疗技巧 

分 类 号：R681.5[医药卫生—骨科学]