椎间孔镜治疗复发性腰椎间盘突出症的临床分析  

Clinical analysis of percutaneous transforaminal endoscopic discectomy in the treatment of recurrent lumbar disc herniation

作　　者：白一冰[1] 王力文[1] 郭立新[1] 薛海滨[1] 谢明玖[1] 简伟[1] 

机构地区：[1]解放军总参谋部总医院脊柱微创病区,北京100091

出　　处：《颈腰痛杂志》2014年第5期345-348,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的评估椎间孔镜治疗复发性椎间盘突出症的临床疗效。方法 2010-10-2011-06根据纳入标准筛选30例复发性椎间盘突出症患者,行椎间孔镜下神经根松解术治疗,采用VAS、ODI两项调查评估系统对患者进行长期随访,根据结果评估椎间孔镜对该类疾病的手术疗效。结果根据VAS评分标准,平均视觉模拟评分由7.50±1.27降至4.80±2.44,(P<0.05);ODI评分由39.70±16.69降至36.30±17.37,(P<0.05);优良率为30%。结论椎间孔镜在治疗复发性腰椎间盘突出症时,针对再发的神经根腹侧压迫,是有效而有优势的,但就复发性腰椎间盘突出症而言,影响其临床症状的因素较繁杂,多数情况下因背侧瘢痕粘连或内固定占位不良等限制,椎间孔镜无法对其进行手术处理的,总体疗效低于再次开放手术。Objective To evaluate the efficacy of percutaneous transforaminal endoscopic discectomy （PTED） in the treatment of recurrent lumbar disc herniation. Methods A total of 30 patients with recurrent lumbar disc herniation, who were treated by PTED in our hospital from October 2010 to June 2011,were enrolled in this study. The visual analogue score （VAS） and Oswestry score were measured in the preoperative and postoperative phases. The patients were followed up for 18-32 months,the average time of follow-up was 24 months. Results Postoperative VAS and Oswestry score were significantly lower than preoperation（P〈0.05）. Conclusion PTED in the treatment of recurrent lumbar disc herniation has advantages for the compression of ventral nerve roots. For recurrent lumbar disc herniation,clinical manifestations were complex. The result is a failed surgery of PTED in many cases,the effective rate is lower than traditional open surgery.

关 键 词：复发性椎间盘突出症 后外侧 经椎间孔 椎间孔镜 翻修术 

分 类 号：R681.53[医药卫生—骨科学]