经皮椎间孔镜术治疗复发性腰椎间盘突出症的效果观察  

Effects of percutaneous transforaminal endoscopic discectomy on recurrent lumbar disc herniation

作　　者：胡德亚 薛晨辉 Hu Deya;Xue Chenhui(Department of Orthopedics,the First People's Hospital of Jinzhong,Jinzhong 030600,China)

机构地区：[1]山西省晋中市第一人民医院骨科,030600

出　　处：《中国实用医刊》2018年第23期94-97,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨经皮椎间孔镜术治疗复发性腰椎间盘突出症(LDH)的临床效果。方法选择晋中市第一人民医院2016年2月至2018年2月诊治的复发性腰椎间盘突出症患者96例,根据患者意愿选择手术方式,并将其分为椎间孔镜组(n=48)和椎板开窗组(n=48),其中椎间孔镜组使用经皮椎间孔镜术治疗,椎板开窗组使用椎板开窗髓核摘除术治疗。观察两组围术期指标,术前及术后6个月腿疼、腰痛视觉模拟(VAS)评分和腰椎日本骨科协会评估治疗分数(JOA)评分及其改善率,并记录相关不良反应。结果椎间孔镜组术中出血量、首次下床时间及出院时间明显少于椎板开窗组,差异有统计学意义(P<0.05);椎间孔镜组手术时间长于椎板开窗组,差异有统计学意义(P<0.05)。术前、术后6个月,两组腿疼、腰痛VAS评分,差异均未见统计学意义(P>0.05);术后6个月,两组腿疼、腰痛VAS评分较术前明显降低,差异有统计学意义(P<0.05)。术前、术后6个月,两组腰椎JOA评分及改善率比较,差异均未见统计学意义(P>0.05);术后6个月,两组腰椎JOA评分较术前明显升高,差异有统计学意义(P<0.05)。结论复发性腰椎间盘突出症可使用经皮椎间孔镜术治疗,其治疗效果与椎板开窗髓核摘除术相当,但可减少术中出血量,缩短卧床及住院时间。Objective To study the effects of percutaneous transforaminal endoscopic discectomy (PTED)on recurrent lumbar disc herniation (LDH).Methods Ninety-six patients with recurrent lumbar disc herniation who were diagnosed and treated in the First People's Hospital of Jinzhong from February 2016 to February 2018 were selected.Treatment protocols were chosen as patients'wish,and they were divided into transforaminal endoscopic discectomy group (n=48)and fenestration discectomy group (n =48).Patients in transforaminal endoscopic discectomy group were given PTED,and patients in fenestration discectomy group were treated by fenestration discectomy.The perioperative indexes,and visual analogue scale (VAS)scores of leg pain and low back pain,and lumbar spine JOA score and corresponding improvement rates in the two groups were observed before operation and 6 months after operation.And the related adverse reactions were recorded.Results The intraoperative blood loss,first ambulation time and discharge time in transforaminal endoscopic discectomy group were significantly lower than those in fenestration discectomy group (P<0.05).The operative time in transforaminal endoscopic discectomy group was longer than that in fenestration discectomy group (P<0.05).Before operation and 6 months after operation,there was no statistically significant difference in VAS scores of leg pain and low back pain between the two groups (P>0.05).At 6 months after operation,the VAS scores of leg pain and low back pain of the two groups were significantly lower than those before operation (P<0.05).There was no significant difference in the JOA score or improvement rate between the two groups before operation and 6 months after operation (P>0.05).At 6 months after operation,the lumbar spine JOA scores in the two groups were significantly higher than those before operation (P<0.05).Conclusions Recurrent lumbar disc herniation can be treated by percutaneous transforaminal endoscopic discectomy,of which treatment effects is comparable to fenestration disce

关 键 词：经皮椎间孔镜术 椎板开窗髓核摘除术 复发性 腰椎间盘突出症 

分 类 号：R687.3[医药卫生—骨科学]